Provider Demographics
NPI:1972084648
Name:LOTHIAN, MEGAN (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:LOTHIAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 69TH ST APT 9G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5437
Mailing Address - Country:US
Mailing Address - Phone:201-421-7647
Mailing Address - Fax:
Practice Address - Street 1:150 E 58TH ST FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155-0002
Practice Address - Country:US
Practice Address - Phone:917-720-2764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104551104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker