Provider Demographics
NPI:1437676681
Name:KOWALCHICK, MEGAN VICTORIA (LMSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:VICTORIA
Last Name:KOWALCHICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CANDEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3055
Mailing Address - Country:US
Mailing Address - Phone:855-552-9355
Mailing Address - Fax:855-552-9355
Practice Address - Street 1:23 CANDEE AVE
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-3055
Practice Address - Country:US
Practice Address - Phone:855-552-9355
Practice Address - Fax:855-552-9355
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8766611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical