Healthcare Provider Details

I. General information

NPI: 1114871365
Provider Name (Legal Business Name): MEHGAN R O'DONNELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 THIMBLE SHOALS BLVD STE 203
NEWPORT NEWS VA
23606-4262
US

IV. Provider business mailing address

732 THIMBLE SHOALS BLVD STE 203
NEWPORT NEWS VA
23606-4262
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-8566
  • Fax:
Mailing address:
  • Phone: 757-873-8566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704015175
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: