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Individual

MS. MEGAN RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, CADC

Contact information

Practice address
9702 STONESTREET RD STE 120, LOUISVILLE, KY 40272-6812
(513) 834-7063
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(513) 834-7063

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
127535
KY
101YP2500X
Professional Counselor
Primary
171809
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100534640
KY
Enumeration date
10/31/2016
Last updated
07/13/2021
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