Provider Demographics
NPI:1972034163
Name:MEREDITH, MEGAN NICHOLE (LPCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICHOLE
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:NICHOLE
Other - Last Name:PARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:2707 BRECKENRIDGE STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303
Mailing Address - Country:US
Mailing Address - Phone:270-313-2566
Mailing Address - Fax:
Practice Address - Street 1:2707 BRECKENRIDGE STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303
Practice Address - Country:US
Practice Address - Phone:270-313-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251496101YM0800X
KY172098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health