Individual provider Active NPI

Megan E. Lavery, LPC

  • Mental Health Counselor
  • Saint Marys, GA
National Provider Identifier
1154859957
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC011638 Issued in GA
Practice address
102 Lakeshore Dr Ste B
Saint Marys, GA 31558-3875
Phone
(912) 882-3800
Fax
(912) 882-3303
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT011078 GA
Mental Health Counselor 101YM0800X LPC011638 GA Primary

Addresses

Primary practice location

102 Lakeshore Dr Ste B
Saint Marys, GA 31558-3875

Mailing address

2762 Forest Ridge Dr
Fernandina Beach, FL 32034-0411
Phone (270) 791-6656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC011638GAMDMental Health Counselor
MT011078GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthorse Psychiatry LLC Past Accepting new patients
Body Mind Healing LLC Mental Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1154859957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 FOREST RIDGE DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320340411",
            "telephone_number": "270-791-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 LAKESHORE DR STE B",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583875",
            "telephone_number": "912-882-3800",
            "fax_number": "912-882-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERY",
        "first_name": "MEGAN",
        "middle_name": "E.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT011078",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.