| Doctor Name: | DENISE MEGINNISS |
| NPI Number: | 1104216530 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180.004419 |
| Business Practice Address: | 440 W Boughton Rd Bolingbrook, IL - 604401892 |
| Business Phone Number: | 8885422119 |
| Business Fax Number: | 6308637293 |
| Mailing Address: | 440 W Boughton Rd, BOLINGBROOK |
| State: | IL |
| Postal Code: | 604401892 |
| Phone Number: | 8885422119 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2015 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.004419 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |