Provider Demographics
NPI:1275234205
Name:WHITE, MEGAN A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:A
Last Name:WHITE
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 1:310 S DILLARD ST STE 170
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3500
Mailing Address - Country:US
Mailing Address - Phone:407-867-7908
Mailing Address - Fax:
Practice Address - Street 1:310 S DILLARD ST STE 170
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3500
Practice Address - Country:US
Practice Address - Phone:407-867-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW42331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical