=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700651262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN F CLICK LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2023
-----------------------------------------------------
Last Update Date | 11/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 DIXIE LN
-----------------------------------------------------
City | NEW MARKET
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22844-9551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-740-3169
-----------------------------------------------------
Fax | 540-740-4536
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 W CRISER RD STE 300
-----------------------------------------------------
City | FRONT ROYAL
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22630-2360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-247-5780
-----------------------------------------------------
Fax | 540-636-7171
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0904016001
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------