Provider Demographics
NPI:1083350128
Name:KOSTER, MEGAN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:KOSTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5116 N MAPLESTONE AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6776
Mailing Address - Country:US
Mailing Address - Phone:951-533-8245
Mailing Address - Fax:
Practice Address - Street 1:1009 W SANETTA ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-5047
Practice Address - Country:US
Practice Address - Phone:208-576-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID42169261QM0855X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health