Provider Demographics
NPI:1639328958
Name:RAY, MEGAN EMILY (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:EMILY
Last Name:RAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:EMILY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:2101 COURAGE DR # MS 10-270
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6717
Mailing Address - Country:US
Mailing Address - Phone:707-784-4921
Mailing Address - Fax:707-399-4957
Practice Address - Street 1:2101 COURAGE DR # MS 10-270
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6717
Practice Address - Country:US
Practice Address - Phone:707-784-4921
Practice Address - Fax:707-399-4957
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW75758104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker