Provider Demographics
NPI:1689358566
Name:AMMER-BAREFIELD, MEGAN LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:AMMER-BAREFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LYNN
Other - Last Name:AMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1045 W NORTH SHORE AVE APT 1W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4624
Mailing Address - Country:US
Mailing Address - Phone:219-741-0226
Mailing Address - Fax:
Practice Address - Street 1:913 W WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6709
Practice Address - Country:US
Practice Address - Phone:872-843-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490253581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical