Healthcare Provider Details

I. General information

NPI: 1558859355
Provider Name (Legal Business Name): MEGAN JESSICA GARLAND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN JESSICA LEWIS

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 COMPASS POINT DR
SAINT CHARLES MO
63301-4404
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax:
Mailing address:
  • Phone: 660-885-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2022020359
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: