MEDICARE: MEGAN MARIE HOMER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC014050	PA

General Provider Information

NPI Number	:	1194468660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARIE HOMER LPC

Provider Business Mailing Address
First Line	:	4053 PIONEER LAKE RD
Second Line	:
City	:	CHERRY TREE
State	:	PA
Zip	:	15724-8134
Country	:	US
Telephone Number	:	724-388-8711
Fax Number	:

Provider Business Practice Location Address
First Line	:	4053 PIONEER LAKE RD
Second Line	:
City	:	CHERRY TREE
State	:	PA
Zip	:	15724-8134
Country	:	US
Telephone Number	:	724-388-8711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	04/13/2022

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