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General NPI Number Information
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NPI Number | 1750847505
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Entity Type | Individual
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Provider Name | MEGAN MAYA LACHANCE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 360 PEAK ONE DR STE 100
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City | FRISCO
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State | CO
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Zip | 80443-5948
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Country | US
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Telephone | 970-423-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 MOUNT MASSIVE DR
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City | LEADVILLE
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State | CO
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Zip | 80461-3443
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Country | US
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Telephone | 720-673-6929
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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 |
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License Number State |
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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 | CSW.09928584
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License Number State | CO
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