Healthcare Provider Details

I. General information

NPI: 1811882699
Provider Name (Legal Business Name): MEGAN BERGERON CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 FAYETTEVILLE RD STE 106
DURHAM NC
27713-6248
US

IV. Provider business mailing address

1740 NIGHT SKY TRL
APEX NC
27502-4505
US

V. Phone/Fax

Practice location:
  • Phone: 919-228-8276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number745298
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: