Provider Demographics
NPI:1730736232
Name:O'CONNOR, MEAGHAN ANTOINETTE (LPC, NCC, CCTP)
Entity type:Individual
Prefix:MS
First Name:MEAGHAN
Middle Name:ANTOINETTE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LPC, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2761
Mailing Address - Country:US
Mailing Address - Phone:662-371-1711
Mailing Address - Fax:844-512-2577
Practice Address - Street 1:202 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-2761
Practice Address - Country:US
Practice Address - Phone:662-371-1711
Practice Address - Fax:844-512-2577
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty