Provider Demographics
NPI:1740619675
Name:MEGAHAN-WESTLEY, JANET (BA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MEGAHAN-WESTLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LITTLE GLOUCESTER RD APT P29
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3610
Mailing Address - Country:US
Mailing Address - Phone:856-784-6807
Mailing Address - Fax:856-784-6825
Practice Address - Street 1:205 WEST BRANCH AVE
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021
Practice Address - Country:US
Practice Address - Phone:856-784-6807
Practice Address - Fax:856-784-6825
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJM22153847452564103K00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)