Provider Demographics
NPI:1912893900
Name:MATHEWS, MEGHAN RAE (MSW LISW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:RAE
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:MRS
Other - First Name:MEGHAN
Other - Middle Name:R
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1638 PEMBROKE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1265
Mailing Address - Country:US
Mailing Address - Phone:614-323-6390
Mailing Address - Fax:
Practice Address - Street 1:1638 PEMBROKE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1265
Practice Address - Country:US
Practice Address - Phone:614-323-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.25067961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical