Provider Demographics
NPI:1336503440
Name:MCDERMOTT, MEGAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCDERMOTT
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 1:2627 W HIRSCH ST # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1609
Mailing Address - Country:US
Mailing Address - Phone:312-493-9520
Mailing Address - Fax:
Practice Address - Street 1:1057 W BELDEN AVE
Practice Address - Street 2:APT 3B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3269
Practice Address - Country:US
Practice Address - Phone:312-493-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0181881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical