Healthcare Provider Details

I. General information

NPI: 1952729949
Provider Name (Legal Business Name): MEGAN NESS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN EASTMAN MSW, LICSW

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 CEDAR LAKE RD S
SAINT LOUIS PARK MN
55416-1481
US

IV. Provider business mailing address

5881 CEDAR LAKE ROAD S 2ND FLOOR OFFICE #6
SAINT LOUIS PARK MN
55416-1481
US

V. Phone/Fax

Practice location:
  • Phone: 763-269-7879
  • Fax:
Mailing address:
  • Phone: 763-269-7879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21156
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: