Provider Demographics
NPI:1477977999
Name:BROWN, MEGAN HANSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:HANSON
Last Name:BROWN
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 1:3596 E 800 N
Mailing Address - Street 2:
Mailing Address - City:MENAN
Mailing Address - State:ID
Mailing Address - Zip Code:83434-5055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3596 E 800 N
Practice Address - Street 2:
Practice Address - City:MENAN
Practice Address - State:ID
Practice Address - Zip Code:83434-5055
Practice Address - Country:US
Practice Address - Phone:208-317-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-33452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional