MEDICARE: MEAGAN KENNEDY LPC-A

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	101Y00000X	Counselor	0704018214	VA
2	101YM0800X	Mental Health Counselor	8351	SC

General Provider Information

NPI Number	:	1245946698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN KENNEDY LPC-A

Provider Business Mailing Address
First Line	:	132 ELLIOTT ST
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-2152
Country	:	US
Telephone Number	:	434-272-8372
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 PINEY FOREST RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-3315
Country	:	US
Telephone Number	:	434-272-9372
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	04/22/2026

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Directions to “ MEAGAN KENNEDY LPC-A” Practice Location

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