Provider Demographics
NPI:1588029136
Name:GARZA, MEGAN RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:GARZA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15946 N 173RD AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-0253
Mailing Address - Country:US
Mailing Address - Phone:623-688-7900
Mailing Address - Fax:
Practice Address - Street 1:15946 N 173RD AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-0253
Practice Address - Country:US
Practice Address - Phone:623-688-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2024-03-11
Deactivation Date:2018-05-17
Deactivation Code:
Reactivation Date:2021-08-28
Provider Licenses
StateLicense IDTaxonomies
AZ206731041C0700X
WY13341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty