Provider Demographics
NPI:1730837733
Name:BORRE, MEGAN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:BORRE
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 1:5090 HAYWARD LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156
Mailing Address - Country:US
Mailing Address - Phone:224-456-4005
Mailing Address - Fax:
Practice Address - Street 1:155 N MICHIGAN AVE STE 380
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7710
Practice Address - Country:US
Practice Address - Phone:773-340-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0220951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical