Healthcare Provider Details

I. General information

NPI: 1053210484
Provider Name (Legal Business Name): MEGAN FEURY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 PINE KNOB RD
CLARKSTON MI
48348-3767
US

IV. Provider business mailing address

23691 LONDONDERRY
NOVI MI
48375-3630
US

V. Phone/Fax

Practice location:
  • Phone: 248-623-5300
  • Fax:
Mailing address:
  • Phone: 248-916-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: