Provider Demographics
NPI:1932579794
Name:BURTON, MEGAN ANN (LCPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:MT
Mailing Address - Zip Code:59436-0067
Mailing Address - Country:US
Mailing Address - Phone:406-590-6991
Mailing Address - Fax:
Practice Address - Street 1:630 5TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:MT
Practice Address - Zip Code:59436
Practice Address - Country:US
Practice Address - Phone:406-590-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-13101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional