Healthcare Provider Details

I. General information

NPI: 1326656836
Provider Name (Legal Business Name): MEGAN LEANNE CUELLAR MS, LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN LEANNE JONES

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5788 ECKHERT RD
SAN ANTONIO TX
78240-3900
US

IV. Provider business mailing address

1423 DELGADO ST
SAN ANTONIO TX
78207-1947
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-0014
  • Fax:
Mailing address:
  • Phone: 832-975-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94069
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: