Healthcare Provider Details

I. General information

NPI: 1942676739
Provider Name (Legal Business Name): MEGHAN CRAIG LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2015
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 OLD DOVER RD
ROCHESTER NH
03867-3464
US

IV. Provider business mailing address

25 OLD DOVER RD
ROCHESTER NH
03867-3464
US

V. Phone/Fax

Practice location:
  • Phone: 603-516-9428
  • Fax:
Mailing address:
  • Phone: 603-516-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number01CGM92301
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2435
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: