Provider Demographics
NPI:1285249839
Name:BROWN, MEGAN YUNG (MA, LPCC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:YUNG
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 IDYLWILD DR # 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3609
Mailing Address - Country:US
Mailing Address - Phone:859-813-2885
Mailing Address - Fax:
Practice Address - Street 1:1002 IDYLWILD DR # 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3609
Practice Address - Country:US
Practice Address - Phone:859-813-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY245207101YM0800X
KY280442101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100862990Medicaid