Provider Demographics
NPI:1811762792
Name:PHILIPPI, MEGAN ELISE (MSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELISE
Last Name:PHILIPPI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 WOOD BARK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4641
Mailing Address - Country:US
Mailing Address - Phone:702-885-7234
Mailing Address - Fax:
Practice Address - Street 1:95 S ARROYO GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-5017
Practice Address - Country:US
Practice Address - Phone:702-735-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10875-M171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator