Provider Demographics
NPI:1740606474
Name:O'MALLEY, MEG J (LCSW)
Entity type:Individual
Prefix:
First Name:MEG
Middle Name:J
Last Name:O'MALLEY
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 1:12 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2739
Mailing Address - Country:US
Mailing Address - Phone:844-292-0111
Mailing Address - Fax:207-701-4487
Practice Address - Street 1:12 UNION ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2739
Practice Address - Country:US
Practice Address - Phone:844-292-0111
Practice Address - Fax:207-701-4487
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5125101YM0800X
171M00000X
MELC218301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator