Provider Demographics
NPI:1518141217
Name:MONDS, MEGAN ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:MONDS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:433 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6219
Mailing Address - Country:US
Mailing Address - Phone:360-565-0999
Mailing Address - Fax:360-457-4841
Practice Address - Street 1:433 E 8TH ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6219
Practice Address - Country:US
Practice Address - Phone:360-565-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW610414231041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical