Healthcare Provider Details

I. General information

NPI: 1285503409
Provider Name (Legal Business Name): MEGAN LEKULITCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8580 VERREE RD
PHILADELPHIA PA
19111-1370
US

IV. Provider business mailing address

1300 N LAWRENCE ST APT 3
PHILADELPHIA PA
19122-4416
US

V. Phone/Fax

Practice location:
  • Phone: 215-214-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL018257
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: