Healthcare Provider Details

I. General information

NPI: 1093001273
Provider Name (Legal Business Name): MEGAN EVITA LAVERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2011
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EDEN RD
LANCASTER PA
17601-4713
US

IV. Provider business mailing address

825 EDEN RD # M61
LANCASTER PA
17601-4713
US

V. Phone/Fax

Practice location:
  • Phone: 609-658-2163
  • Fax:
Mailing address:
  • Phone: 609-658-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: