Provider Demographics
NPI:1578609129
Name:CAMP, MEGAN LAURA (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LAURA
Last Name:CAMP
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 STATE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-9650
Mailing Address - Country:US
Mailing Address - Phone:413-665-1051
Mailing Address - Fax:
Practice Address - Street 1:181 NORTHAMPTON ST.
Practice Address - Street 2:SUITE B-4
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1181
Practice Address - Country:US
Practice Address - Phone:413-575-6394
Practice Address - Fax:413-527-7730
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1112501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA111250OtherLIC. INDEP. CLIN. SOCIAL
MACAP22981Medicare ID - Type Unspecified