Provider Demographics
NPI:1457835050
Name:CHEUNG, MEGAN CHINGMUI
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHINGMUI
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CRESCENT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6345
Mailing Address - Country:US
Mailing Address - Phone:781-354-6830
Mailing Address - Fax:617-357-5323
Practice Address - Street 1:75 KNEELAND ST STE 204
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1906
Practice Address - Country:US
Practice Address - Phone:857-990-3319
Practice Address - Fax:617-357-5323
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1023031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1023031OtherLICSW