Provider Demographics
NPI:1447405824
Name:CARTER, MEGHAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:LONERGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:4270 MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2306
Mailing Address - Country:US
Mailing Address - Phone:203-451-6170
Mailing Address - Fax:
Practice Address - Street 1:4270 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2306
Practice Address - Country:US
Practice Address - Phone:203-451-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT77851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235918Medicaid