MEDICARE: MRS. MEGAN LEONHARDT HEYWOOD LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184286908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN LEONHARDT HEYWOOD LPC

Provider Business Mailing Address
First Line	:	PO BOX 245
Second Line	:
City	:	HIGLEY
State	:	AZ
Zip	:	85236-0245
Country	:	US
Telephone Number	:	480-712-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	3336 E CHANDLER HEIGHTS RD STE 123
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85298-4263
Country	:	US
Telephone Number	:	480-712-2660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2019
Last Update Date	:	08/29/2019

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