Provider Demographics
NPI:1417432311
Name:COLLINS, MEGAN DAVIS (JD, MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DAVIS
Last Name:COLLINS
Suffix:
Gender:F
Credentials:JD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-2105
Mailing Address - Country:US
Mailing Address - Phone:978-362-2206
Mailing Address - Fax:
Practice Address - Street 1:288 SALEM RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-2105
Practice Address - Country:US
Practice Address - Phone:978-362-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1112161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical