Healthcare Provider Details

I. General information

NPI: 1770253775
Provider Name (Legal Business Name): MEGHAN LAVEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RICHMOND SQ STE 103K
PROVIDENCE RI
02906-5166
US

IV. Provider business mailing address

50 OMAHA BLVD
WARWICK RI
02889-1613
US

V. Phone/Fax

Practice location:
  • Phone: 401-728-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number15810
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: