Healthcare Provider Details

I. General information

NPI: 1053043620
Provider Name (Legal Business Name): MEGAN HUFFMAN MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/30/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 LE PHILLIP CT NE
CONCORD NC
28025-2900
US

IV. Provider business mailing address

PO BOX 1025
CHINA GROVE NC
28023-1025
US

V. Phone/Fax

Practice location:
  • Phone: 704-720-7770
  • Fax:
Mailing address:
  • Phone: 704-791-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP017761
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: