Provider Demographics
NPI:1437647740
Name:SHEA, MEGAN AUSTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:AUSTIN
Last Name:SHEA
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 1:80 LORANGE PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1983
Mailing Address - Country:US
Mailing Address - Phone:808-782-7380
Mailing Address - Fax:
Practice Address - Street 1:80 LORANGE PL
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1983
Practice Address - Country:US
Practice Address - Phone:808-782-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-36331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical