Provider Demographics
NPI:1003290321
Name:HANEKOM, MEGAN (LPC, LAC, NCC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HANEKOM
Suffix:
Gender:F
Credentials:LPC, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 W 26TH AVE STE 120A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5317
Mailing Address - Country:US
Mailing Address - Phone:303-925-4580
Mailing Address - Fax:303-925-4581
Practice Address - Street 1:2490 W 26TH AVE STE 120A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5317
Practice Address - Country:US
Practice Address - Phone:303-925-4580
Practice Address - Fax:303-925-4581
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015773101YM0800X
COACD.0001323101YP2500X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)