Provider Demographics
NPI:1316530785
Name:MAGRUDER, MEREDITH L (LPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:MAGRUDER
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 1:6305 COUNTRY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7617
Mailing Address - Country:US
Mailing Address - Phone:214-893-4737
Mailing Address - Fax:
Practice Address - Street 1:3550 PARKWOOD BLVD STE 401
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1905
Practice Address - Country:US
Practice Address - Phone:214-945-4515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health