Healthcare Provider Details

I. General information

NPI: 1649778606
Provider Name (Legal Business Name): MEGHAN LEE VOORIS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BURLINGTON MALL ROAD
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

LAHEY HOSPITAL & MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8013
  • Fax:
Mailing address:
  • Phone: 781-744-8610
  • Fax: 781-744-5235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120903
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: