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General NPI Number Information
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NPI Number | 1619779923
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Entity Type | Individual
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Provider Name | MEGAN PHELAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 671 LUMPKIN CAMPGROUND RD S STE 100
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0931
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Country | US
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Telephone | 678-866-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 4331 THURMON TANNER RD
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-2829
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Country | US
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Telephone | 404-657-2252
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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 | CSW009525
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License Number State | GA
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