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NPI Code Detail

MEDICARE: MEGAN SIMON KEKICH

MEDICARE: MEGAN SIMON KEKICH
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-23272NC

General Provider Information

NPI Number : 1467990275
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN SIMON KEKICH
Provider Business Mailing Address
First Line : 6813 FAIRVIEW RD STE D
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3364
Country : US
Telephone Number : 980-553-0195
Fax Number :
Provider Business Practice Location Address
First Line : 6813 FAIRVIEW RD STE D
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3364
Country : US
Telephone Number : 980-553-0195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2017
Last Update Date : 01/09/2024

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