Provider Demographics
NPI:1508272766
Name:FRAWLEY, MEGHAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:FRAWLEY
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 1:1963 N E ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-3919
Mailing Address - Country:US
Mailing Address - Phone:909-881-6146
Mailing Address - Fax:909-881-3479
Practice Address - Street 1:665 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1109
Practice Address - Country:US
Practice Address - Phone:909-708-8158
Practice Address - Fax:909-380-7030
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1055811041C0700X
CA70743101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health