Provider Demographics
NPI:1265615819
Name:EARLES, MEGAN M (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:M
Last Name:EARLES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:M
Other - Last Name:UMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1861 PLACIDA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4961
Mailing Address - Country:US
Mailing Address - Phone:941-474-7170
Mailing Address - Fax:
Practice Address - Street 1:1861 PLACIDA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4961
Practice Address - Country:US
Practice Address - Phone:941-474-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW101401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical