Provider Demographics
NPI:1669865978
Name:JOHNSON, MEGAN (MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 FOREST HILL BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5812
Mailing Address - Country:US
Mailing Address - Phone:561-721-2887
Mailing Address - Fax:561-721-2893
Practice Address - Street 1:3333 FOREST HILL BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5812
Practice Address - Country:US
Practice Address - Phone:561-721-2887
Practice Address - Fax:561-721-2893
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW46661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical