Provider Demographics
NPI:1982235487
Name:CAVANAUGH, MEGAN THERESA (LPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:THERESA
Last Name:CAVANAUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 STONEHEDGE LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-7003
Mailing Address - Country:US
Mailing Address - Phone:717-919-8510
Mailing Address - Fax:
Practice Address - Street 1:4349 CARLISLE PIKE STE 101
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4252
Practice Address - Country:US
Practice Address - Phone:717-775-3380
Practice Address - Fax:717-775-3382
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010283101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health