Healthcare Provider Details

I. General information

NPI: 1104311364
Provider Name (Legal Business Name): MEGAN ELIZABETH HUTCHINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 W WESLEY CT
LAKEWOOD CO
80227-2144
US

IV. Provider business mailing address

9701 W WESLEY CT
LAKEWOOD CO
80227-2144
US

V. Phone/Fax

Practice location:
  • Phone: 518-774-4550
  • Fax:
Mailing address:
  • Phone: 518-774-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC17278
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09925092
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: