Healthcare Provider Details

I. General information

NPI: 1063321065
Provider Name (Legal Business Name): MEAGAN FERGUSON DANIELS NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S DAVID RD STE 900
LAGRANGE GA
30241
US

IV. Provider business mailing address

6254 WARM SPRINGS RD APT B21
COLUMBUS GA
31909-9140
US

V. Phone/Fax

Practice location:
  • Phone: 478-200-9931
  • Fax:
Mailing address:
  • Phone: 844-790-3469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: