Provider Demographics
NPI:1346915733
Name:HESS, MEGAN (LMSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14285 ROAD 29
Mailing Address - Street 2:
Mailing Address - City:DOLORES
Mailing Address - State:CO
Mailing Address - Zip Code:81323-9359
Mailing Address - Country:US
Mailing Address - Phone:970-560-1791
Mailing Address - Fax:
Practice Address - Street 1:1400 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-9098
Practice Address - Country:US
Practice Address - Phone:505-599-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-11342104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker