Healthcare Provider Details
I. General information
NPI: 1275878662
Provider Name (Legal Business Name): MEGAN A COLLINS LMFT, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/11/2012
Last Update Date: 12/15/2024
Certification Date: 12/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20501 VENTURA BLVD STE 170
WOODLAND HILLS CA
91364-6258
US
IV. Provider business mailing address
9461 CHARLEVILLE BLVD STE 1185
BEVERLY HILLS CA
90212-3017
US
V. Phone/Fax
- Phone: 818-579-5693
- Fax:
- Phone: 424-209-7172
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 151021 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | 24-101 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: