Healthcare Provider Details

I. General information

NPI: 1275455966
Provider Name (Legal Business Name): MEGAN ELIZABETH JAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN ELIZABETH MARCHAND

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4775 BARNES RD STE L
COLORADO SPRINGS CO
80917-1650
US

IV. Provider business mailing address

5645 MARSHALL CREEK DR
COLORADO SPRINGS CO
80924-8104
US

V. Phone/Fax

Practice location:
  • Phone: 719-644-6131
  • Fax:
Mailing address:
  • Phone: 719-232-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0024303
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: