Provider Demographics
NPI:1962643064
Name:YORK, MEGAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:YORK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:THOMPSON AND MCCORMACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10712 COUNTY ROAD 8130
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-5784
Mailing Address - Country:US
Mailing Address - Phone:417-505-9843
Mailing Address - Fax:417-256-4858
Practice Address - Street 1:203 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-3524
Practice Address - Country:US
Practice Address - Phone:417-505-9843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060180501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2006018050Medicaid
MO612447OtherBLUE CROSS BLUE SHIELD