Healthcare Provider Details

I. General information

NPI: 1225932734
Provider Name (Legal Business Name): MEGAN MARY PERRAULT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MAIN ST STE 201A
SALEM NH
03079-3171
US

IV. Provider business mailing address

70 BROADWAY ST
WESTFORD MA
01886-2148
US

V. Phone/Fax

Practice location:
  • Phone: 978-999-2165
  • Fax:
Mailing address:
  • Phone: 978-999-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: