Provider Demographics
NPI:1679398267
Name:HERSCHER, MEGAN CASSIDY (PHD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:CASSIDY
Last Name:HERSCHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:M
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:206 BRECHIN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2163
Mailing Address - Country:US
Mailing Address - Phone:703-861-9862
Mailing Address - Fax:
Practice Address - Street 1:9111 CROSS PARK DR STE D200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4521
Practice Address - Country:US
Practice Address - Phone:703-861-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health