Healthcare Provider Details

I. General information

NPI: 1023776325
Provider Name (Legal Business Name): MEGAN JANE MCMURDY MA, LGPC, LGPAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 12/03/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 W PATRICK ST STE 3
FREDERICK MD
21701-6907
US

IV. Provider business mailing address

12820 LITTLE ELLIOTT DR APT 8
HAGERSTOWN MD
21742-2885
US

V. Phone/Fax

Practice location:
  • Phone: 240-888-9642
  • Fax:
Mailing address:
  • Phone: 717-713-8809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberATG291
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP11813
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: