Provider Demographics
NPI:1396865184
Name:FACER, MEGAN CASTLE (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CASTLE
Last Name:FACER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:LOUISE
Other - Last Name:CASTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CAPITOLA DR
Mailing Address - Street 2:STE. 310
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4496
Mailing Address - Country:US
Mailing Address - Phone:919-474-6389
Mailing Address - Fax:
Practice Address - Street 1:100 CAPITOLA DR
Practice Address - Street 2:STE. 310
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4496
Practice Address - Country:US
Practice Address - Phone:919-474-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1220101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105333Medicaid