Provider Demographics
NPI:1710307111
Name:MCINTYRE, MEGAN FAULKNER (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:FAULKNER
Last Name:MCINTYRE
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 1:6269 COLBERT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3012
Mailing Address - Country:US
Mailing Address - Phone:504-281-2601
Mailing Address - Fax:504-821-2040
Practice Address - Street 1:2601 TULANE AVE STE 500
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7400
Practice Address - Country:US
Practice Address - Phone:504-821-2601
Practice Address - Fax:504-821-2040
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA108851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical