Provider Demographics
NPI:1326287558
Name:MEYERHOFFER, MEGAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:MEYERHOFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MANDALA
Other - Middle Name:COUNSELING
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2108 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1985
Mailing Address - Country:US
Mailing Address - Phone:502-299-6446
Mailing Address - Fax:
Practice Address - Street 1:2108 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1985
Practice Address - Country:US
Practice Address - Phone:502-299-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical