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General NPI Number Information
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NPI Number | 1093348575
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Entity Type | Organization
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Legal Business Name | MEGAN MCDERMOTT LCSW, LLC
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1431 N CLAREMONT AVE FL 2
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City | CHICAGO
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State | IL
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Zip | 60622-1702
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Country | US
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Telephone | 312-493-9520
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Fax |
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Provider Business Mailing Address
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Address Line | 2627 W HIRSCH ST # 1
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City | CHICAGO
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State | IL
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Zip | 60622-1609
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Country | US
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Telephone | 312-493-9529
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Fax |
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Authorized Official
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Title or Position | MANAGER/REGISTERED AGENT
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Name | MEGAN MARIE MCDERMOTT
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Credential | LCSW
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Telephone | 312-493-9520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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