Provider Demographics
NPI:1639412984
Name:DONNELLY, MEGAN LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LYNN
Last Name:DONNELLY
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 1:27 NAEK RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3965
Mailing Address - Country:US
Mailing Address - Phone:860-872-9825
Mailing Address - Fax:860-870-9384
Practice Address - Street 1:27 NAEK RD
Practice Address - Street 2:SUITE 4
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3965
Practice Address - Country:US
Practice Address - Phone:860-872-9825
Practice Address - Fax:860-870-9384
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0082481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical