Provider Demographics
NPI:1518474964
Name:GLOVER, MEAGAN OLIVIA (LMSW)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:OLIVIA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:OLIVIA
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 WISEMAN RD
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-5537
Mailing Address - Country:US
Mailing Address - Phone:615-598-5183
Mailing Address - Fax:615-598-5183
Practice Address - Street 1:1803 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2201
Practice Address - Country:US
Practice Address - Phone:615-598-5183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000010926104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker