Healthcare Provider Details

I. General information

NPI: 1457761686
Provider Name (Legal Business Name): MEAGHAN HENNINGS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4408 JOHN F KENNEDY PKWY APT I306
FORT COLLINS CO
80525-3599
US

IV. Provider business mailing address

4408 JOHN F KENNEDY PKWY APT I306
FORT COLLINS CO
80525-3599
US

V. Phone/Fax

Practice location:
  • Phone: 307-262-4589
  • Fax:
Mailing address:
  • Phone: 307-262-4589
  • Fax: 307-233-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPCSW-522
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-911
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: