MEDICARE: MEGHAN SHOOK LPCA

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	105856	KY

General Provider Information

NPI Number	:	1316431901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN SHOOK LPCA

Provider Business Mailing Address
First Line	:	100 BUENO XING
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-7900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 PARIS PIKE
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-9701
Country	:	US
Telephone Number	:	678-294-1766
Fax Number	:

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

Provider Enumeration Date	:	06/18/2018
Last Update Date	:	06/18/2018

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Directions to “ MEGHAN SHOOK LPCA” Practice Location

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