Healthcare Provider Details

I. General information

NPI: 1316814494
Provider Name (Legal Business Name): MRS. MEGAN AMANDA VARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E GRAND RIVER AVE
EAST LANSING MI
48823-4958
US

IV. Provider business mailing address

4925 ALGONQUIN WAY
OKEMOS MI
48864-1001
US

V. Phone/Fax

Practice location:
  • Phone: 517-295-3726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401018174
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: