MEDICARE: MS. ANN ELIZABETH GEAGAN 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	6264	SC
2	1041C0700X	Clinical Social Worker	113770	MA

General Provider Information

NPI Number	:	1346306412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN ELIZABETH GEAGAN MSW

Provider Business Mailing Address
First Line	:	2408 BERT DR
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4322
Country	:	US
Telephone Number	:	774-207-8023
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 BERT DR
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4322
Country	:	US
Telephone Number	:	774-207-8023
Fax Number	:

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

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	11/04/2025

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