Provider Demographics
NPI:1972017002
Name:LESOWSKI, MEGAN (MA, LPC, CADCI)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LESOWSKI
Suffix:
Gender:F
Credentials:MA, LPC, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SE 223RD AVE STE 165
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2577
Mailing Address - Country:US
Mailing Address - Phone:503-836-8836
Mailing Address - Fax:503-836-8144
Practice Address - Street 1:1201 SE 223RD AVE STE 165
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2577
Practice Address - Country:US
Practice Address - Phone:503-836-8836
Practice Address - Fax:503-836-8144
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor