Healthcare Provider Details

I. General information

NPI: 1467943167
Provider Name (Legal Business Name): MEGAN LINDSTROM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 DEBORAH RD SE STE 205
RIO RANCHO NM
87124-6619
US

IV. Provider business mailing address

3169 ASHKIRK LOOP SE
RIO RANCHO NM
87124-3614
US

V. Phone/Fax

Practice location:
  • Phone: 281-202-7207
  • Fax: 505-212-6336
Mailing address:
  • Phone: 281-202-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2022-0499
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-10323
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: