Provider Demographics
NPI:1982229977
Name:MAHORSKI, MEGHAN ASHLEY (LPC, SAC-IT, NCC)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:ASHLEY
Last Name:MAHORSKI
Suffix:
Gender:F
Credentials:LPC, SAC-IT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 S OAK PARK CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1927
Mailing Address - Country:US
Mailing Address - Phone:262-818-3456
Mailing Address - Fax:
Practice Address - Street 1:720 N EAST AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4892
Practice Address - Country:US
Practice Address - Phone:414-587-5752
Practice Address - Fax:414-800-2405
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4539101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional