Healthcare Provider Details

I. General information

NPI: 1942547674
Provider Name (Legal Business Name): MEGAN DEANNA CAUDLE LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CHATEAU DR SW STE 145
HUNTSVILLE AL
35801-6437
US

IV. Provider business mailing address

250 CHATEAU DR SW STE 145
HUNTSVILLE AL
35801-6437
US

V. Phone/Fax

Practice location:
  • Phone: 256-801-8937
  • Fax: 256-517-8355
Mailing address:
  • Phone: 256-801-8937
  • Fax: 256-517-8355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3021
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: