Provider Demographics
NPI:1013098961
Name:CLEARY, MEGHAN JUNE (MSW, LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:JUNE
Last Name:CLEARY
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813-1 CHESAPEAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1835
Mailing Address - Country:US
Mailing Address - Phone:410-221-2266
Mailing Address - Fax:410-221-2878
Practice Address - Street 1:813-1 CHESAPEAKE DRIVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1835
Practice Address - Country:US
Practice Address - Phone:410-221-2266
Practice Address - Fax:410-221-2878
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD829621000OtherMAGELLAN
MDKBM964798201OtherBCBS
MD479302100Medicaid
MDF7930012OtherBCBS FEDERAL
MD479302100Medicaid