Provider Demographics
NPI:1194610675
Name:EVJEN, MEGAN P (LBSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:P
Last Name:EVJEN
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 32ND ST S STE 1
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6304
Mailing Address - Country:US
Mailing Address - Phone:701-264-5200
Mailing Address - Fax:701-999-2779
Practice Address - Street 1:1411 32ND ST S STE 1
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6304
Practice Address - Country:US
Practice Address - Phone:701-264-5200
Practice Address - Fax:701-999-2779
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND5043104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker