Healthcare Provider Details

I. General information

NPI: 1669169892
Provider Name (Legal Business Name): MEAGHAN TRUGLIO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2367 W CLOVELLY LN
ST AUGUSTINE FL
32092
US

IV. Provider business mailing address

2367 W CLOVELLY LN
ST AUGUSTINE FL
32092
US

V. Phone/Fax

Practice location:
  • Phone: 518-469-0597
  • Fax:
Mailing address:
  • Phone: 518-469-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15598
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: