MEDICARE: MRS. MEGAN ANN WERNER 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1407176795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN ANN WERNER LPC

Provider Business Mailing Address
First Line	:	2153 E JOYCE BLVD
Second Line	:	STE 201
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4714
Country	:	US
Telephone Number	:	479-575-9471
Fax Number	:	479-587-9392

Provider Business Practice Location Address
First Line	:	3715 N BUSINESS DR
Second Line	:	STE 104
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-5204
Country	:	US
Telephone Number	:	479-521-1532
Fax Number	:	479-587-9392

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

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	01/31/2017

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