Provider Demographics
NPI:1669804506
Name:BROWN, MEGAN MICHELLE (LCPC, NCC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 N BURTON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5314
Mailing Address - Country:US
Mailing Address - Phone:208-761-2730
Mailing Address - Fax:208-576-6912
Practice Address - Street 1:4840 N ROSEPOINT WAY STE C
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0952
Practice Address - Country:US
Practice Address - Phone:208-213-8347
Practice Address - Fax:208-576-6912
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-6032101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor