Provider Demographics
NPI:1124842273
Name:ARRASTIA-CHISHOLM, MEAGAN CARIDAD (LPC)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:CARIDAD
Last Name:ARRASTIA-CHISHOLM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4629
Mailing Address - Country:US
Mailing Address - Phone:407-421-4058
Mailing Address - Fax:
Practice Address - Street 1:313 N MITCHELL ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4629
Practice Address - Country:US
Practice Address - Phone:407-421-4058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015093101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional