Provider Demographics
NPI:1548453004
Name:SMITH, MEGAN LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 EMERALD ST
Mailing Address - Street 2:PMB#448
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3626
Mailing Address - Country:US
Mailing Address - Phone:626-476-3265
Mailing Address - Fax:
Practice Address - Street 1:23 CENTRAL SQ STE 300
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3707
Practice Address - Country:US
Practice Address - Phone:603-355-2244
Practice Address - Fax:603-355-2299
Is Sole Proprietor?:No
Enumeration Date:2007-08-19
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25983103T00000X
NH1509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist