Healthcare Provider Details

I. General information

NPI: 1285109967
Provider Name (Legal Business Name): MEGAN LINDBERGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RAF LAKENHEATH
BRANDON SUFFOLK
IP279PN
GB

IV. Provider business mailing address

UNIT 5210 BOX 230
APO AE
09461-5210
US

V. Phone/Fax

Practice location:
  • Phone: 314-238-2410
  • Fax:
Mailing address:
  • Phone: 314-238-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013546
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: