Provider Demographics
NPI:1255220414
Name:SOOY, MEGAN ANNA (LAC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANNA
Last Name:SOOY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 MONMOUTH AVE APT 602
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-2283
Mailing Address - Country:US
Mailing Address - Phone:609-204-9380
Mailing Address - Fax:
Practice Address - Street 1:331 TILTON RD STE 28
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1201
Practice Address - Country:US
Practice Address - Phone:609-833-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00881500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor