Healthcare Provider Details

I. General information

NPI: 1811801335
Provider Name (Legal Business Name): MRS. MEGAN SHERLOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 HARMONY RD
EATONTON GA
31024-9601
US

IV. Provider business mailing address

1340 PONDER PINES RD
MADISON GA
30650-5573
US

V. Phone/Fax

Practice location:
  • Phone: 678-444-3836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: