Healthcare Provider Details

I. General information

NPI: 1215744461
Provider Name (Legal Business Name): MEGAN CAMP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2340 E MEYER BLVD
KANSAS CITY MO
64132-1105
US

IV. Provider business mailing address

16304 E 28TH ST S
INDEPENDENCE MO
64055-2215
US

V. Phone/Fax

Practice location:
  • Phone: 816-777-4467
  • Fax:
Mailing address:
  • Phone: 816-777-4467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.028215
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: