Provider Demographics
NPI:1184172298
Name:MARSAC, MEGHAN L (PHD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:L
Last Name:MARSAC
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:L
Other - Last Name:GUTHRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST # HA398
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-7001
Mailing Address - Country:US
Mailing Address - Phone:859-323-3850
Mailing Address - Fax:859-257-6066
Practice Address - Street 1:800 ROSE ST # HA398
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-3850
Practice Address - Fax:859-257-6066
Is Sole Proprietor?:No
Enumeration Date:2016-09-18
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170534103TC0700X
PAPS016896103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical