Healthcare Provider Details

I. General information

NPI: 1720382997
Provider Name (Legal Business Name): MEGAN DIANE MCLEAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 S COLORADO BLVD STE 501
DENVER CO
80222-3322
US

IV. Provider business mailing address

1547 S SHERMAN ST
DENVER CO
80210-2621
US

V. Phone/Fax

Practice location:
  • Phone: 303-695-1601
  • Fax:
Mailing address:
  • Phone: 847-894-3271
  • Fax: 303-466-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1747
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: