Provider Demographics
NPI:1144989492
Name:KAMPSTRA, MEGAN SUE (LPCC)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:SUE
Last Name:KAMPSTRA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 SHOREVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-4212
Mailing Address - Country:US
Mailing Address - Phone:320-444-5659
Mailing Address - Fax:
Practice Address - Street 1:225 W LINCOLN AVE STE 104
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2146
Practice Address - Country:US
Practice Address - Phone:218-531-1424
Practice Address - Fax:218-531-1420
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1865101YM0800X
MNCC03142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health