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General NPI Number Information
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NPI Number | 1851764849
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Entity Type | Individual
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Provider Name | MEGAN CARMEN LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 10524 GRAND RIVER RD
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City | BRIGHTON
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State | MI
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Zip | 48116-9597
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Country | US
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Telephone | 810-225-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 2927 WILDWOOD CT
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City | SALINE
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State | MI
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Zip | 48176-1679
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Country | US
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Telephone | 860-514-3154
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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 |
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License Number State |
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