Provider Demographics
NPI:1689247918
Name:TROUP, MEGAN COLLEEN (LAC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:COLLEEN
Last Name:TROUP
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:COLLEEN
Other - Last Name:PETZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 TUDOR PL
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3781
Mailing Address - Country:US
Mailing Address - Phone:973-479-5772
Mailing Address - Fax:
Practice Address - Street 1:4 GOLD MINE RD
Practice Address - Street 2:
Practice Address - City:ROXBURY TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07836-9122
Practice Address - Country:US
Practice Address - Phone:973-479-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00577800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor