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General NPI Number Information
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NPI Number | 1689022816
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Entity Type | Individual
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Provider Name | MEGAN QUARLES BAKER SOEN MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 14 HEALTH SERVICES DR
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City | DEKALB
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State | IL
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Zip | 60115-9637
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Country | US
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Telephone | 815-758-8616
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Fax |
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Provider Business Mailing Address
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Address Line | 308 STRATFORD PL APT 32
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2381
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Country | US
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Telephone | 630-450-4385
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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 | 150.101423
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License Number State | IL
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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 | 149019974
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License Number State | IL
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