MEDICARE: MEGAN KATHLEEN HAST MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C009550	NC

General Provider Information

NPI Number	:	1295946523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN KATHLEEN HAST MSW

Provider Business Mailing Address
First Line	:	1501 FRUITVALE AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-2322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3608 UNIVERSITY DR STE 101
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-6260
Country	:	US
Telephone Number	:	919-830-0794
Fax Number	:	919-226-0026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	08/07/2020

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