1679895817 NPI number — MRS. MEGAN M WILLIAMS MFT, LPC, RPT

Table of content: MRS. MEGAN M WILLIAMS MFT, LPC, RPT (NPI 1679895817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679895817 NPI number — MRS. MEGAN M WILLIAMS MFT, LPC, RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
MEGAN
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MFT, LPC, RPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEANS
Provider Other First Name:
MEGAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFT, LPC, RPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679895817
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2105 S 54TH ST STE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROGERS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72758-8191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-372-4859
Provider Business Mailing Address Fax Number:
479-268-4723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2105 S 54TH ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ROGERS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72758-8169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-372-4859
Provider Business Practice Location Address Fax Number:
479-268-4723
Provider Enumeration Date:
02/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  P121110 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: M1211011 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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