MEDICARE: DR. MEGAN R PICKENS LPC-S

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	64995	TX
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1417262544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN R PICKENS LPC-S

Provider Business Mailing Address
First Line	:	752 N MAIN ST UNIT 1115
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-3282
Country	:	US
Telephone Number	:	817-617-2638
Fax Number	:	817-840-6416

Provider Business Practice Location Address
First Line	:	1013 E DALLAS ST STE 109
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-2052
Country	:	US
Telephone Number	:	817-617-2638
Fax Number	:	817-840-6416

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

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	01/07/2026

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