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NPI Code Detail

MEDICARE: MAURA EAGAN LPCC

MEDICARE:   MAURA  EAGAN  LPCC
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
1390200000XStudent in an Organized Health Care Education/Training Program
2101YP2500XProfessional CounselorE.2001615OH

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 : 1629404025
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAURA EAGAN LPCC
Provider Business Mailing Address
First Line : PO BOX 715194
Second Line :
City : COLUMBUS
State : OH
Zip : 43271-5194
Country : US
Telephone Number : 614-355-8004
Fax Number : 614-355-2220
Provider Business Practice Location Address
First Line : 765 PIERCE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-2425
Country : US
Telephone Number : 614-223-1650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2013
Last Update Date : 01/27/2020

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Directions to “ MAURA EAGAN LPCC” Practice Location

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