Provider Demographics
NPI:1639993066
Name:ALCORN, MEAGAN E (LMSW, LAC)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:E
Last Name:ALCORN
Suffix:
Gender:F
Credentials:LMSW, LAC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:E
Other - Last Name:BALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9415 E HARRY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5084
Mailing Address - Country:US
Mailing Address - Phone:316-651-1224
Mailing Address - Fax:
Practice Address - Street 1:9415 E HARRY ST STE 800
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5084
Practice Address - Country:US
Practice Address - Phone:316-651-1224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS879101YA0400X
KS13941104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)