Provider Demographics
NPI:1750631461
Name:CARNAHAN, MEGAN (LISW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CARNAHAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N LINN ST
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2143
Mailing Address - Country:US
Mailing Address - Phone:319-383-3689
Mailing Address - Fax:
Practice Address - Street 1:123 N LINN ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2143
Practice Address - Country:US
Practice Address - Phone:319-383-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2014-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0077621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical