Provider Demographics
NPI:1699307553
Name:COUCH, MEGAN SPENSER (HHA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:SPENSER
Last Name:COUCH
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 CARVER PARK 2 CIR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1604
Mailing Address - Country:US
Mailing Address - Phone:864-364-9230
Mailing Address - Fax:
Practice Address - Street 1:517 CARVER PARK 2 CIR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1604
Practice Address - Country:US
Practice Address - Phone:864-364-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1780902516Medicaid