Provider Demographics
NPI:1033592266
Name:MCSHANE, MEGHANN MARIE (MSSW)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:MARIE
Last Name:MCSHANE
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:MEGHANN
Other - Middle Name:MARIE
Other - Last Name:MCSHANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSSW
Mailing Address - Street 1:1923 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5654
Mailing Address - Country:US
Mailing Address - Phone:423-317-9344
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:2018 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5718
Practice Address - Country:US
Practice Address - Phone:865-544-0406
Practice Address - Fax:865-544-0480
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TN104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker