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General NPI Number Information
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NPI Number | 1386450567
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Entity Type | Individual
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Provider Name | MEGAN BRIDGET CLEMICK LSW
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 24 LEXINGTON RD
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City | HOWELL
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State | NJ
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Zip | 07731-2140
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Country | US
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Telephone | 732-367-2390
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Fax |
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Provider Business Mailing Address
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Address Line | 653 GARRISON RD
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City | MONROEVILLE
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State | NJ
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Zip | 08343-4511
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Country | US
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Telephone | 908-907-2954
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05987500
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License Number State | NJ
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