Provider Demographics
NPI:1184597783
Name:BRYANT, MEAGHAN SUZANNE (LLMSW)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:SUZANNE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BIRDSALL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MI
Mailing Address - Zip Code:49262-9806
Mailing Address - Country:US
Mailing Address - Phone:706-676-6317
Mailing Address - Fax:
Practice Address - Street 1:2017 4TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-4572
Practice Address - Country:US
Practice Address - Phone:517-581-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851119651104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker