Healthcare Provider Details

I. General information

NPI: 1134599517
Provider Name (Legal Business Name): MEGHAN LOUISE SUTTON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OLD MILTON PKWY STE 175
ALPHARETTA GA
30005-2460
US

IV. Provider business mailing address

601 W MICHIGAN ST
ORLANDO FL
32805-6203
US

V. Phone/Fax

Practice location:
  • Phone: 770-389-8100
  • Fax:
Mailing address:
  • Phone: 321-842-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3392
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT 2311
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT002124
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: