Provider Demographics
NPI:1043595663
Name:MCEACHERN, MEAGHAN L
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:L
Last Name:MCEACHERN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2219
Mailing Address - Country:US
Mailing Address - Phone:785-841-7297
Mailing Address - Fax:785-576-1587
Practice Address - Street 1:1803 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1710
Practice Address - Country:US
Practice Address - Phone:785-841-7297
Practice Address - Fax:785-576-1587
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
KSLP03292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No172V00000XOther Service ProvidersCommunity Health Worker