Provider Demographics
NPI:1386519759
Name:EVERETT, MEGAN DANIELLA
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DANIELLA
Last Name:EVERETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21409 NW 13TH CT APT 605
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2792
Mailing Address - Country:US
Mailing Address - Phone:786-838-2221
Mailing Address - Fax:
Practice Address - Street 1:7971 RIVIERA BLVD STE 405
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6450
Practice Address - Country:US
Practice Address - Phone:305-924-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician