Provider Demographics
NPI:1013509280
Name:MARTIN, MEAGAN (LMFT)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 BLUE RIDGE RD STE 240
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6475
Mailing Address - Country:US
Mailing Address - Phone:984-222-8000
Mailing Address - Fax:984-222-8001
Practice Address - Street 1:2605 BLUE RIDGE RD STE 240
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6475
Practice Address - Country:US
Practice Address - Phone:984-222-8000
Practice Address - Fax:984-222-8001
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
NC12051A106H00000X
NC2361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist