Provider Demographics
NPI:1801199872
Name:DOUGLAS, MEGAN ELIZABETH BROWN (LICSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH BROWN
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1231 N GARDEN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5162
Mailing Address - Country:US
Mailing Address - Phone:360-734-4616
Mailing Address - Fax:
Practice Address - Street 1:1231 N GARDEN ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5162
Practice Address - Country:US
Practice Address - Phone:360-734-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 000097281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical