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NPI Code Detail

MEDICARE: MEGHAN FAWCETT P.C.C.

MEDICARE: MEGHAN FAWCETT P.C.C.
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
1101YP2500XProfessional Counselor
2101YA0400XAddiction (Substance Use Disorder) CounselorE.0500277OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457503435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN FAWCETT P.C.C.
Provider Business Mailing Address
First Line : 6841 PAXTON RD
Second Line :
City : BOARDMAN
State : OH
Zip : 44512-4531
Country : US
Telephone Number : 330-509-1331
Fax Number :
Provider Business Practice Location Address
First Line : 960 BOARDMAN CANFIELD RD
Second Line :
City : BOARDMAN
State : OH
Zip : 44512-4220
Country : US
Telephone Number : 330-953-1977
Fax Number : 330-953-2555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2008
Last Update Date : 01/21/2019

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