Healthcare Provider Details

I. General information

NPI: 1316211816
Provider Name (Legal Business Name): MEGAN L MCLAIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S MAIN ST SUITE 11
STUTTGART AR
72160-6718
US

IV. Provider business mailing address

1902 S MAIN ST SUITE 11
STUTTGART AR
72160-6718
US

V. Phone/Fax

Practice location:
  • Phone: 870-673-9370
  • Fax: 870-672-7010
Mailing address:
  • Phone: 870-673-9370
  • Fax: 870-672-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1853-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: