Provider Demographics
NPI:1578446217
Name:MEGHAN WALLACE COUNSELING SERVICES
Entity type:Organization
Organization Name:MEGHAN WALLACE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-362-3040
Mailing Address - Street 1:413 WALLACE ST UNIT 2D
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2297
Mailing Address - Country:US
Mailing Address - Phone:267-644-5258
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST STE 1504
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6215
Practice Address - Country:US
Practice Address - Phone:215-362-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty