Provider Demographics
NPI:1427868306
Name:KONDRASUK, MEAGAN NICOLE (MS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:NICOLE
Last Name:KONDRASUK
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:NICOLE
Other - Last Name:MCMAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:327 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17340-1221
Mailing Address - Country:US
Mailing Address - Phone:631-566-4015
Mailing Address - Fax:
Practice Address - Street 1:490 EISENHOWER DR STE 7
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5247
Practice Address - Country:US
Practice Address - Phone:717-219-3659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018113101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health