Provider Demographics
NPI:1750952859
Name:PENA, MEGAN RAE (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:PENA
Suffix:
Gender:
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6154 LAWN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78242-2515
Mailing Address - Country:US
Mailing Address - Phone:210-870-8715
Mailing Address - Fax:
Practice Address - Street 1:6154 LAWN VALLEY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78242-2515
Practice Address - Country:US
Practice Address - Phone:210-870-8715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86063101YP2500X
TX15333101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)