Healthcare Provider Details

I. General information

NPI: 1588404875
Provider Name (Legal Business Name): MEGAN BLEIL LGPC, RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2024
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15948 FREDERICK RD
WOODBINE MD
21797-8526
US

IV. Provider business mailing address

904 AUTUMN RIDGE CT
MOUNT AIRY MD
21771-5755
US

V. Phone/Fax

Practice location:
  • Phone: 410-936-3981
  • Fax:
Mailing address:
  • Phone: 410-946-4294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17350
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number918
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: