Provider Demographics
NPI:1821633579
Name:STAUFFER, MEGAN MCDERMOTT (MSW, IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MCDERMOTT
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MSW, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 BRENDA CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1115 BRENDA CT
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9341
Practice Address - Country:US
Practice Address - Phone:919-259-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-41638174N00000X
NCP0184791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174N00000XOther Service ProvidersLactation Consultant, Non-RN