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General NPI Number Information
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NPI Number | 1689168635
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Entity Type | Organization
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Legal Business Name | MEGHAN DEAN LCSW LLC
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 825 W STATE ST STE 102B
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City | GENEVA
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State | IL
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Zip | 60134
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Country | US
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Telephone | 331-248-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 825 W STATE ST STE 102B
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City | GENEVA
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State | IL
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Zip | 60134-2080
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Country | US
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Telephone | 331-248-5893
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MEGHAN DEAN
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Credential | LCSW
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Telephone | 331-248-5893
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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 | 149008676
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License Number State | IL
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