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General NPI Number Information
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NPI Number | 1316531437
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Entity Type | Individual
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Provider Name | MEGAN MAAZAOUI LICSW - DP00945457
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Gender | Female
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1021 QUARRIER ST STE 414
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City | CHARLESTON
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State | WV
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Zip | 25301-2331
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Country | US
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Telephone | 43-403-6763
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Fax | 304-340-3688
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Provider Business Mailing Address
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Address Line | 900 5TH AVE APT 1
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City | SAINT ALBANS
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State | WV
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Zip | 25177-2978
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Country | US
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Telephone |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | DP00945457
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License Number State | WV
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