Healthcare Provider Details

I. General information

NPI: 1841100757
Provider Name (Legal Business Name): MEGAN WALLEY SOMSANITH LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 E BALTIMORE PIKE STE 210
MEDIA PA
19063-5126
US

IV. Provider business mailing address

128 SUMMIT RD
MEDIA PA
19063-1402
US

V. Phone/Fax

Practice location:
  • Phone: 484-202-0751
  • Fax:
Mailing address:
  • Phone: 412-952-7804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW127847
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: