Healthcare Provider Details

I. General information

NPI: 1760574842
Provider Name (Legal Business Name): MEGAN PERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N MAIN ST UNIT B
SPRINGBORO OH
45066-7520
US

IV. Provider business mailing address

301 S MAIN ST UNIT 596
MONROE OH
45050-6425
US

V. Phone/Fax

Practice location:
  • Phone: 937-507-6520
  • Fax: 937-889-2895
Mailing address:
  • Phone: 937-507-6520
  • Fax: 937-889-2895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149-010657
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0206382
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: