1093054454 NPI number — MRS. MEAGAN MICHELL MCPHERSON LPC, M.ED, NCC

Table of content: MRS. MEAGAN MICHELL MCPHERSON LPC, M.ED, NCC (NPI 1093054454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093054454 NPI number — MRS. MEAGAN MICHELL MCPHERSON LPC, M.ED, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCPHERSON
Provider First Name:
MEAGAN
Provider Middle Name:
MICHELL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, M.ED, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093054454
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
885 FERNCLIFF CV
Provider Second Line Business Mailing Address:
SUITE NUMBER 2
Provider Business Mailing Address City Name:
SOUTHAVEN
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38671-2433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-342-2700
Provider Business Mailing Address Fax Number:
662-342-7300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
885 FERNCLIFF CV
Provider Second Line Business Practice Location Address:
SUITE NUMBER 2
Provider Business Practice Location Address City Name:
SOUTHAVEN
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38671-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-342-2700
Provider Business Practice Location Address Fax Number:
662-342-7300
Provider Enumeration Date:
02/05/2013

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:  1727 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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