Burgess, Megan
Burgess, Megan is an sole proprietor health care provider with primary practice located at 4795 Broadway , Gary IN 46409. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Burgess, Megan can be contacted via phone (219) 887-3688.Contact Information
Primary practice address
4795 Broadway
Gary IN 46409
Phone: (219) 887-3688
Fax: (219) 887-2666
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 33005040A | Indiana |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 87000928A | Indiana |
Profile Details
| NPI number | 1164891404 |
|---|---|
| LBN Legal business name | Burgess, Megan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2015 |
| Last updated | Sep 16th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164891404 | NPPES |
| Indiana | Other | 87000928A | LCAC LICENSE |
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