Provider Demographics
NPI:1356899801
Name:WILLEAN, MEGHANN (PHD, LPC)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:
Last Name:WILLEAN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 US HIGHWAY 22 STE C
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-5082
Mailing Address - Country:US
Mailing Address - Phone:908-236-2763
Mailing Address - Fax:
Practice Address - Street 1:496 US HIGHWAY 22 STE C
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NJ
Practice Address - Zip Code:08833-5082
Practice Address - Country:US
Practice Address - Phone:908-236-2763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00487900101YP2500X
NJ833626101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool