Provider Demographics
NPI:1740006816
Name:MCGUGAN, MEGAN C
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:MCGUGAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LUMEN
Mailing Address - Street 2:26210 HARPER AVE SUITE 200
Mailing Address - City:SAINT CLAIR SHORE
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1955
Mailing Address - Country:US
Mailing Address - Phone:888-485-8636
Mailing Address - Fax:
Practice Address - Street 1:26210 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2203
Practice Address - Country:US
Practice Address - Phone:888-485-8636
Practice Address - Fax:586-218-3367
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician