Provider Demographics
NPI:1780108258
Name:GRADY, MEGAN C (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:GRADY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:C
Other - Last Name:LATOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25101 CHAGRIN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5694
Mailing Address - Country:US
Mailing Address - Phone:216-468-5000
Mailing Address - Fax:216-456-8128
Practice Address - Street 1:6601 CENTERVILLE BUSINESS PKWY STE 310
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2691
Practice Address - Country:US
Practice Address - Phone:216-468-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC16763104100000X
MELC181201041C0700X
OHI.2103020104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical