Provider Demographics
NPI:1578730206
Name:MEAGHER, RAYMOND EDWARD (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:EDWARD
Last Name:MEAGHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NE 7TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1362
Mailing Address - Country:US
Mailing Address - Phone:541-287-2232
Mailing Address - Fax:
Practice Address - Street 1:1309 NE 7TH ST STE C
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1362
Practice Address - Country:US
Practice Address - Phone:541-287-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical