MEDICARE: LISA M EGAN 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	101Y00000X	Counselor	16666	TX
2	101YM0800X	Mental Health Counselor	16666	TX
3	101YP2500X	Professional Counselor

Other Identifiers

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

General Provider Information

NPI Number	:	1588897714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA M EGAN LPC

Provider Business Mailing Address
First Line	:	1809 WESTLAKE DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-8507
Country	:	US
Telephone Number	:	972-233-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 CEDAR SPRINGS RD STE 310
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-7873
Country	:	US
Telephone Number	:	972-233-6800
Fax Number	:

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

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	11/10/2020

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Directions to “ LISA M EGAN LPC” Practice Location

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