Provider Demographics
NPI:1073274726
Name:DIEME, MEGAN (LSCSW, LCSW, RPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DIEME
Suffix:
Gender:F
Credentials:LSCSW, LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W 75TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2241
Mailing Address - Country:US
Mailing Address - Phone:913-850-4833
Mailing Address - Fax:
Practice Address - Street 1:10000 W 75TH ST STE 104
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2241
Practice Address - Country:US
Practice Address - Phone:913-850-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS47701041C0700X
MO20160383531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical