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General NPI Number Information
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NPI Number | 1053969238
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Entity Type | Individual
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Provider Name | MEGAN COLLEEN BICKETT LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 2054 S GREEN RD
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-4213
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Country | US
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Telephone | 216-291-9210
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Fax |
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Provider Business Mailing Address
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Address Line | 101 YELLOWSTONE CT
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City | BEREA
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State | OH
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Zip | 44017-3146
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Country | US
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Telephone | 440-864-2439
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2203096-SUPV
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License Number State | OH
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