Healthcare Provider Details

I. General information

NPI: 1992533111
Provider Name (Legal Business Name): MEGAN SPENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 DUNN RD
HAZELWOOD MO
63042-1740
US

IV. Provider business mailing address

7569 OXFORD DR
CLAYTON MO
63105-2807
US

V. Phone/Fax

Practice location:
  • Phone: 314-721-2433
  • Fax:
Mailing address:
  • Phone: 314-518-5317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026003704
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: