Provider Demographics
NPI:1548675598
Name:LEIGH-MANUELL, MEGHAN MCDONALD (LPC)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:MCDONALD
Last Name:LEIGH-MANUELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:DIANE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12195 HWY 92
Mailing Address - Street 2:SUITE 114 PMB 313
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:678-444-4505
Mailing Address - Fax:678-444-4506
Practice Address - Street 1:207 MAGNOLIA CREEK WAY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188
Practice Address - Country:US
Practice Address - Phone:678-444-4505
Practice Address - Fax:678-444-4506
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007503101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor