Healthcare Provider Details

I. General information

NPI: 1790678928
Provider Name (Legal Business Name): MEGAN MOTLEY-MACCALL LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 BROAD ST
DURHAM NC
27705-3534
US

IV. Provider business mailing address

6913 LYNN TOWNES CT
RALEIGH NC
27613-4099
US

V. Phone/Fax

Practice location:
  • Phone: 919-797-9879
  • Fax: 919-747-4269
Mailing address:
  • Phone: 984-332-0328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21461
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: