Provider Demographics
NPI:1497596555
Name:FLENNIKEN, MEAGAN (LPC)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:FLENNIKEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:209 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-1405
Mailing Address - Country:US
Mailing Address - Phone:678-458-1664
Mailing Address - Fax:
Practice Address - Street 1:157 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-1014
Practice Address - Country:US
Practice Address - Phone:404-348-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional