Provider Demographics
NPI:1255818365
Name:MILLER, MEGAN R (LISW-S)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RACHAEL
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4331
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:
Practice Address - Street 1:329 N WEST ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4331
Practice Address - Country:US
Practice Address - Phone:419-221-3072
Practice Address - Fax:419-481-9865
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2103137-SUPV1041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical