Healthcare Provider Details

I. General information

NPI: 1609683945
Provider Name (Legal Business Name): MEGAN MARIE WESTCOTT MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST STE 2060
CHICAGO IL
60611-2994
US

IV. Provider business mailing address

259 E ERIE ST STE 2060
CHICAGO IL
60611-2994
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-6022
  • Fax: 312-695-5672
Mailing address:
  • Phone: 312-695-6022
  • Fax: 312-695-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.115167
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150115167
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: