Healthcare Provider Details

I. General information

NPI: 1750697587
Provider Name (Legal Business Name): MEGAN HORWITZ PLUMSTEAD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 DAYTON AVE STE 327
SAINT PAUL MN
55104-6495
US

IV. Provider business mailing address

1619 DAYTON AVE STE 327
SAINT PAUL MN
55104-6495
US

V. Phone/Fax

Practice location:
  • Phone: 248-797-4833
  • Fax:
Mailing address:
  • Phone: 248-797-4833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6301014531
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301014531
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number6301014531
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number6301014531
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number6301014531
License Number StateMI
# 6
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301014531
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: