Healthcare Provider Details

I. General information

NPI: 1891119087
Provider Name (Legal Business Name): MEGAN BEELEY MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN PERRY

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST STE A
CORTLAND NY
13045-3191
US

IV. Provider business mailing address

165 MAIN ST STE A
CORTLAND NY
13045-3191
US

V. Phone/Fax

Practice location:
  • Phone: 607-753-0234
  • Fax:
Mailing address:
  • Phone: 607-753-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP124022
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: