MEDICARE: MAEGAN STAATS 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	101YP2500X	Professional Counselor	PC0008385	PA

General Provider Information

NPI Number	:	1255733515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAEGAN STAATS LPC

Provider Business Mailing Address
First Line	:	PO BOX 3428
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19381-3428
Country	:	US
Telephone Number	:	302-562-2798
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 WESTTOWN RD
Second Line	:	SUITE A
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-8902
Country	:	US
Telephone Number	:	484-372-0830
Fax Number	:

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	10/20/2015

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