Provider Demographics
NPI:1700196540
Name:DESMOND, MEGGAN (LISW-S)
Entity Type:Individual
Prefix:
First Name:MEGGAN
Middle Name:
Last Name:DESMOND
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:MEGGAN
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:3216 GLENCAIRN AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5465 MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2155
Practice Address - Country:US
Practice Address - Phone:419-885-8800
Practice Address - Fax:419-885-8600
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1000922104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker