Healthcare Provider Details

I. General information

NPI: 1083569610
Provider Name (Legal Business Name): MEGAN ANN KORALY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 S DARIEN DR
ENCINITAS CA
92024-4235
US

IV. Provider business mailing address

128 S DARIEN DR
ENCINITAS CA
92024-4235
US

V. Phone/Fax

Practice location:
  • Phone: 619-880-0032
  • Fax:
Mailing address:
  • Phone: 619-880-0032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number137188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: