Provider Demographics
NPI:1609568278
Name:MACISAAC, MEGHAN COAKLEY-LAUB (LCSW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:COAKLEY-LAUB
Last Name:MACISAAC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CRANBURY WOODS RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1905
Mailing Address - Country:US
Mailing Address - Phone:914-439-2681
Mailing Address - Fax:
Practice Address - Street 1:9 CRANBURY WOODS RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1905
Practice Address - Country:US
Practice Address - Phone:914-439-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0148681041C0700X
CA1008721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical