Provider Demographics
NPI:1649429580
Name:MCINTYRE, MEGAN MAIRE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MAIRE
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:HABEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3831 TYRONE BLVD N STE 201E
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-4114
Mailing Address - Country:US
Mailing Address - Phone:727-308-6902
Mailing Address - Fax:
Practice Address - Street 1:3831 TYRONE BLVD N STE 201E
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-4114
Practice Address - Country:US
Practice Address - Phone:727-308-6902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
TNLSW00000071111041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical