Provider Demographics
NPI:1366747388
Name:MCKUSKY, MEGHAN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MCKUSKY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:168 BERNARD ST E
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-1517
Mailing Address - Country:US
Mailing Address - Phone:508-525-3270
Mailing Address - Fax:
Practice Address - Street 1:61 THOMPSON AVE W
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3114
Practice Address - Country:US
Practice Address - Phone:651-259-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-23
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist