Healthcare Provider Details

I. General information

NPI: 1609268937
Provider Name (Legal Business Name): MEGAN ANTIONETTE BRYANT M.S, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8511 DAVIS LAKE PKWY STE C6-185
CHARLOTTE NC
28269-0536
US

IV. Provider business mailing address

8511 DAVIS LAKE PKWY STE C6-185
CHARLOTTE NC
28269-0536
US

V. Phone/Fax

Practice location:
  • Phone: 910-233-6877
  • Fax:
Mailing address:
  • Phone: 910-233-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11073
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: