Healthcare Provider Details

I. General information

NPI: 1902422876
Provider Name (Legal Business Name): MEGAN NOEL KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MOCCASIN BEND RD
CHATTANOOGA TN
37405-4415
US

IV. Provider business mailing address

108 MOCCASIN BEND RD
CHATTANOOGA TN
37405-4415
US

V. Phone/Fax

Practice location:
  • Phone: 330-685-2379
  • Fax: 330-678-3677
Mailing address:
  • Phone: 330-685-2379
  • Fax: 330-678-3677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8800
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8800
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: