Provider Demographics
NPI:1497035018
Name:TREVINO, MEGHAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:TREVINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:HENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2015 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-4359
Mailing Address - Country:US
Mailing Address - Phone:812-422-7974
Mailing Address - Fax:812-671-0627
Practice Address - Street 1:2015 MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4359
Practice Address - Country:US
Practice Address - Phone:812-422-7974
Practice Address - Fax:812-671-0627
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34009148AOtherSTATE OF INDIANA