Provider Demographics
NPI:1376191528
Name:HARTLEY, MEGAN LUCILLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LUCILLE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LUCILLE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2114 SHIPWAY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3553
Mailing Address - Country:US
Mailing Address - Phone:562-331-0384
Mailing Address - Fax:
Practice Address - Street 1:2114 SHIPWAY AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3553
Practice Address - Country:US
Practice Address - Phone:562-331-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1157041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical