Healthcare Provider Details

I. General information

NPI: 1477977999
Provider Name (Legal Business Name): MEGAN HANSON BROWN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3596 E 800 N
MENAN ID
83434-5055
US

IV. Provider business mailing address

1846 1ST ST # 1048
IDAHO FALLS ID
83401-4415
US

V. Phone/Fax

Practice location:
  • Phone: 208-317-2797
  • Fax:
Mailing address:
  • Phone: 208-248-6488
  • Fax: 208-248-6489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-33452
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: