Provider Demographics
NPI:1457801185
Name:CROFFORD-HOTZ, MEGAN (PHD, LCSW, MED)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:CROFFORD-HOTZ
Suffix:
Gender:F
Credentials:PHD, LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2639
Mailing Address - Country:US
Mailing Address - Phone:646-342-6791
Mailing Address - Fax:
Practice Address - Street 1:21 S 12TH ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3614
Practice Address - Country:US
Practice Address - Phone:215-563-0652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1331241041C0700X
PACW0198001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical