Healthcare Provider Details

I. General information

NPI: 1588349823
Provider Name (Legal Business Name): MEGAN M WYKHUIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR STE 101
STEAMBOAT SPRINGS CO
80487-8853
US

IV. Provider business mailing address

940 CENTRAL PARK DR STE 101
STEAMBOAT SPRINGS CO
80487-8853
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-1632
  • Fax: 970-870-1326
Mailing address:
  • Phone: 970-879-1632
  • Fax: 970-870-1326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929346
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: