Healthcare Provider Details

I. General information

NPI: 1053099101
Provider Name (Legal Business Name): MEGAN LARUE MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5638 PROFESSIONAL CIR
INDIANAPOLIS IN
46241-5042
US

IV. Provider business mailing address

527 ANDERSON ST
GREENCASTLE IN
46135-1728
US

V. Phone/Fax

Practice location:
  • Phone: 888-714-1927
  • Fax:
Mailing address:
  • Phone: 812-236-1018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number33009883A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010537A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: