Healthcare Provider Details

I. General information

NPI: 1477891919
Provider Name (Legal Business Name): MEGAN WALSH LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2013
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 MILLBROOK DR
DOWNERS GROVE IL
60516-4907
US

IV. Provider business mailing address

625 MILLBROOK DR
DOWNERS GROVE IL
60516-4907
US

V. Phone/Fax

Practice location:
  • Phone: 630-728-0957
  • Fax:
Mailing address:
  • Phone: 630-728-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.009746
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: