Provider Demographics
NPI:1902280910
Name:CECIL, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CECIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 WOODLAND AVE
Mailing Address - Street 2:#415
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1909
Mailing Address - Country:US
Mailing Address - Phone:515-222-1999
Mailing Address - Fax:515-224-3949
Practice Address - Street 1:3737 WOODLAND AVE
Practice Address - Street 2:#415
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1909
Practice Address - Country:US
Practice Address - Phone:515-222-1999
Practice Address - Fax:515-224-3949
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health