Provider Demographics
NPI:1518419241
Name:SMOES, MEGAN (MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SMOES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E WINTER AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-2295
Mailing Address - Country:US
Mailing Address - Phone:176-516-8012
Mailing Address - Fax:
Practice Address - Street 1:1101 E WINTER AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-2295
Practice Address - Country:US
Practice Address - Phone:176-516-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor