Provider Demographics
NPI:1730831561
Name:MEADE, MEGAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MEADE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-6450
Mailing Address - Country:US
Mailing Address - Phone:909-851-8042
Mailing Address - Fax:
Practice Address - Street 1:13439 PEYTON DR APT 247
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6013
Practice Address - Country:US
Practice Address - Phone:909-851-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1039081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical