Provider Demographics
NPI:1043081599
Name:TANNER, MEGAN (LMSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:TANNER
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 1:545 LAFAYETTE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440
Mailing Address - Country:US
Mailing Address - Phone:843-904-9121
Mailing Address - Fax:
Practice Address - Street 1:525 LAFAYETTE CIR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-2569
Practice Address - Country:US
Practice Address - Phone:843-546-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2025-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health