Provider Demographics
NPI:1376257592
Name:SANDY, MEGAN RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:SANDY
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 1:6114 FLAGLER LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2905
Mailing Address - Country:US
Mailing Address - Phone:317-619-8964
Mailing Address - Fax:
Practice Address - Street 1:6114 FLAGLER LN
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2905
Practice Address - Country:US
Practice Address - Phone:317-619-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010022A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical