Provider Demographics
NPI:1093259566
Name:CARGILL, MEGHAN ALEXIS (LPCC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ALEXIS
Last Name:CARGILL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ALEXIS
Other - Last Name:POLLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3095 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1983
Mailing Address - Country:US
Mailing Address - Phone:937-293-8300
Mailing Address - Fax:
Practice Address - Street 1:6601 CENTERVILLE BUSINESS PKWY STE 310
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2697
Practice Address - Country:US
Practice Address - Phone:937-637-6735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-18
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404930101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health