Provider Demographics
NPI:1023872389
Name:STEPHENS, MEGAN (LMHC, CRRTS)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LMHC, CRRTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 FENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-1518
Mailing Address - Country:US
Mailing Address - Phone:904-859-7390
Mailing Address - Fax:
Practice Address - Street 1:2616 FENWOOD CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-1518
Practice Address - Country:US
Practice Address - Phone:904-859-7390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22569101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health