Provider Demographics
NPI:1649557794
Name:REDDISH, MEGAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:REDDISH
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 1:18 RONALD CIR
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-1320
Mailing Address - Country:US
Mailing Address - Phone:215-517-5038
Mailing Address - Fax:
Practice Address - Street 1:806 BETHLEHEM PIKE
Practice Address - Street 2:#2A
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1501
Practice Address - Country:US
Practice Address - Phone:215-836-7040
Practice Address - Fax:215-836-7058
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0124271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical