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NPI Code Detail

MEDICARE: MEGAN LYNN BEARDSLEY

MEDICARE: MEGAN LYNN BEARDSLEY
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3106H00000XMarriage & Family Therapist
4101YP2500XProfessional CounselorLPCC9165CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11316192149OTHERCASANTA MARIA ACT

General Provider Information

NPI Number : 1942610142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN LYNN BEARDSLEY
Provider Business Mailing Address
First Line : 1350 E GRAND AVE
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-2422
Country : US
Telephone Number : 805-474-2164
Fax Number :
Provider Business Practice Location Address
First Line : 1350 E GRAND AVE
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-2422
Country : US
Telephone Number : 805-474-2164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2014
Last Update Date : 03/19/2021

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