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General NPI Number Information
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NPI Number | 1104443993
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Entity Type | Individual
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Provider Name | MEGAN CHURCHWELL
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Gender | Female
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 4121 MEDOC DR
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City | KENNER
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State | LA
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Zip | 70065-1922
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Country | US
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Telephone | 504-464-5662
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Fax |
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Provider Business Mailing Address
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Address Line | 501 MANHATTAN BLVD
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City | HARVEY
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State | LA
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Zip | 70058-4443
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Country | US
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Telephone | 504-641-4989
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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 | PLC10247
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License Number State | LA
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