Provider Demographics
NPI:1528416617
Name:LEFORT, MEGHAN (LICSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LEFORT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 TOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-6609
Mailing Address - Country:US
Mailing Address - Phone:401-429-8338
Mailing Address - Fax:
Practice Address - Street 1:805 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-6609
Practice Address - Country:US
Practice Address - Phone:401-429-8338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW015601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical