Provider Demographics
NPI:1932724598
Name:HEWITT, MEGHAN LEIGH
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LEIGH
Last Name:HEWITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4604
Mailing Address - Country:US
Mailing Address - Phone:931-919-2742
Mailing Address - Fax:931-919-2743
Practice Address - Street 1:1823 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4604
Practice Address - Country:US
Practice Address - Phone:931-919-2742
Practice Address - Fax:931-919-2743
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265EMedicaid