Healthcare Provider Details

I. General information

NPI: 1144030792
Provider Name (Legal Business Name): MEGAN YEAKLEY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 FOXGLOVE CT
FORNEY TX
75126-6360
US

IV. Provider business mailing address

5744 SOUTHFORK DR W
ROYSE CITY TX
75189-8095
US

V. Phone/Fax

Practice location:
  • Phone: 903-274-4957
  • Fax:
Mailing address:
  • Phone: 972-951-1395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number97210
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: