Individual provider Active NPI

Megan Hannum, LPCC

  • Professional Counselor
  • Centerville, OH
National Provider Identifier
1609502111
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2505465 Issued in OH
Practice address
6478 Fireside Dr
Centerville, OH 45459-2007
Phone
(937) 307-2823
NPI assigned
Jul 27, 2022
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E.2505465 OH
Professional Counselor 101YP2500X E.2505465 OH Primary

Addresses

Primary practice location

6478 Fireside Dr
Centerville, OH 45459-2007

Mailing address

6478 Fireside Dr
Centerville, OH 45459-2007
Phone (937) 307-2823

Other identifiers 1

IdentifierTypeStateIssuer
0091535MedicaidOH

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
E.2505465OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Authentically Divergent Counseling LLC Professional CurrentSince Jul 13, 2025 Accepting new patients
Wellness Grove, LLC Counselor PastSince Jan 1, 2023 Accepting new patients
Wildwood Counseling Services LLC Counselor Past Accepting new patients
Darcie R Clark LPCC LLC Mental Health PastSince Jan 1, 2024 Accepting new patients
Wellness Grove LLC Mental Health PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 5

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1609502111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6478 FIRESIDE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592007",
            "telephone_number": "937-307-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478 FIRESIDE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592007",
            "telephone_number": "937-307-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNUM",
        "first_name": "MEGAN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2022-07-27",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.2505465",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2505465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091535",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.