Provider Demographics
NPI:1649527466
Name:DEVORE, MEGAN JO (LMFT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JO
Last Name:DEVORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:STOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:4401 WESTOWN PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6721
Mailing Address - Country:US
Mailing Address - Phone:515-800-9515
Mailing Address - Fax:515-241-2305
Practice Address - Street 1:4401 WESTOWN PKWY STE 301
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6721
Practice Address - Country:US
Practice Address - Phone:515-800-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist