Provider Demographics
NPI:1376253799
Name:DENES, MEGAN LYNN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:LYNN
Last Name:DENES
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 1:4094 CANAVERAL GROVES BLVD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-2812
Mailing Address - Country:US
Mailing Address - Phone:321-986-7113
Mailing Address - Fax:
Practice Address - Street 1:4094 CANAVERAL GROVES BLVD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-2812
Practice Address - Country:US
Practice Address - Phone:321-986-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW20459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW20459OtherSTATE LICENSURE