Individual
MEGAN C MACKURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S, MFT
Contact information
Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
(440) 285-4552
Mailing address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.1600104-SUPV
OH
106H00000X
Marriage & Family Therapist
M.1500003
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196156
—
OH
Enumeration date
10/02/2014
Last updated
07/18/2024
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