Healthcare Provider Details

I. General information

NPI: 1427206986
Provider Name (Legal Business Name): MEGHAN REBECCA FLAHERTY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SW COLORADO AVE
BEND OR
97702-1150
US

IV. Provider business mailing address

1108 NE LAFAYETTE AVE
BEND OR
97701-4427
US

V. Phone/Fax

Practice location:
  • Phone: 541-647-4931
  • Fax:
Mailing address:
  • Phone: 541-647-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL3731
License Number StateOR

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: