Provider Demographics
NPI:1023776325
Name:MCMURDY, MEGAN JANE (MA, LGPC, LGPAT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JANE
Last Name:MCMURDY
Suffix:
Gender:F
Credentials:MA, LGPC, LGPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12820 LITTLE ELLIOTT DR APT 8
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2885
Mailing Address - Country:US
Mailing Address - Phone:717-713-8809
Mailing Address - Fax:
Practice Address - Street 1:256 W PATRICK ST STE 3
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6907
Practice Address - Country:US
Practice Address - Phone:240-888-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATG291101Y00000X
MDLGP11813101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAR185998Medicaid