MEDICARE: MR. CHRIS ALAN MENEGAY 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	18331	TX

General Provider Information

NPI Number	:	1417068396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS ALAN MENEGAY LPC

Provider Business Mailing Address
First Line	:	3311 81ST ST
Second Line	:	SUITE F
City	:	LUBBOCK
State	:	TX
Zip	:	79423-2043
Country	:	US
Telephone Number	:	806-780-0003
Fax Number	:	806-780-0007

Provider Business Practice Location Address
First Line	:	3311 81ST ST
Second Line	:	SUITE F
City	:	LUBBOCK
State	:	TX
Zip	:	79423-2043
Country	:	US
Telephone Number	:	806-780-0003
Fax Number	:	806-780-0007

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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