Healthcare Provider Details

I. General information

NPI: 1548726383
Provider Name (Legal Business Name): MEGAN A ABRAMS LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN A ANTHONY LISW

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9049 SPRINGBORO PIKE
MIAMISBURG OH
45342-4926
US

IV. Provider business mailing address

20 E PUGH DR
SPRINGBORO OH
45066-7806
US

V. Phone/Fax

Practice location:
  • Phone: 937-759-0545
  • Fax: 937-759-0549
Mailing address:
  • Phone: 937-776-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1700096-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: