Provider Demographics
NPI:1043638034
Name:CULLEN, MEGAN M (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:CULLEN
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:M
Other - Last Name:CULLEN-KLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5005 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5439
Mailing Address - Country:US
Mailing Address - Phone:608-233-2100
Mailing Address - Fax:608-233-2101
Practice Address - Street 1:5005 UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5439
Practice Address - Country:US
Practice Address - Phone:608-233-2100
Practice Address - Fax:608-233-2101
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16030-132101YA0400X
WI6198-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)