MEDICARE: MEGAN CONDIT-CHADWICK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	64707	CA
2	171M00000X	Case Manager/Care Coordinator
3	1041C0700X	Clinical Social Worker	L12495	OR

General Provider Information

NPI Number	:	1972782381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN CONDIT-CHADWICK LCSW

Provider Business Mailing Address
First Line	:	1011 SW EMKAY DR STE 104
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-3162
Country	:	US
Telephone Number	:	541-323-3477
Fax Number	:	541-323-3478

Provider Business Practice Location Address
First Line	:	1011 SW EMKAY DR STE 104
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-3162
Country	:	US
Telephone Number	:	541-323-3477
Fax Number	:	541-323-3478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	09/20/2021

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