Healthcare Provider Details

I. General information

NPI: 1104138148
Provider Name (Legal Business Name): MEGHAN K MCLAIN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 EVERGREEN DR NE STE 210
GRAND RAPIDS MI
49525-9830
US

IV. Provider business mailing address

3333 EVERGREEN DR NE STE 210
GRAND RAPIDS MI
49525-9830
US

V. Phone/Fax

Practice location:
  • Phone: 616-600-2845
  • Fax: 616-253-8927
Mailing address:
  • Phone: 616-600-2845
  • Fax: 616-253-8927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301017171
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: