Provider Demographics
NPI:1619226743
Name:INGRAM, MEGAN (LCSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:INGRAM
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 N MCCARRAN BLVD # 1008
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-6848
Mailing Address - Country:US
Mailing Address - Phone:775-235-6785
Mailing Address - Fax:
Practice Address - Street 1:1274 SAINT ALBERTS DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2244
Practice Address - Country:US
Practice Address - Phone:775-235-6785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692121041C0700X
VT089.01347001041C0700X
NV9485-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical