Provider Demographics
NPI:1427613546
Name:GOOD, MEAGAN LEE (MA, LPC)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LEE
Last Name:GOOD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 NEW HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:MOHNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19540-8488
Mailing Address - Country:US
Mailing Address - Phone:717-917-7137
Mailing Address - Fax:
Practice Address - Street 1:4675 NEW HOLLAND RD
Practice Address - Street 2:
Practice Address - City:MOHNTON
Practice Address - State:PA
Practice Address - Zip Code:19540-8488
Practice Address - Country:US
Practice Address - Phone:717-917-7137
Practice Address - Fax:484-204-9545
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty