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General NPI Number Information
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NPI Number | 1154733269
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Entity Type | Individual
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Provider Name | MEGAN L STONEBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 06/17/2023
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Provider Practice Location Address
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Address Line | 1843 S BROADWAY AVE STE 205
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City | BOISE
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State | ID
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Zip | 83706-3862
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Country | US
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Telephone | 208-949-8570
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Fax |
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Provider Business Mailing Address
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Address Line | 1843 S BROADWAY AVE STE 205
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City | BOISE
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State | ID
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Zip | 83706-3862
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Country | US
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Telephone | 208-949-8570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32657
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW32657
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License Number State | ID
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