Provider Demographics
NPI:1932534385
Name:REDMON, MEGGHUN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGGHUN
Middle Name:
Last Name:REDMON
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 1:528 S BATAVIA AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-2921
Mailing Address - Country:US
Mailing Address - Phone:630-482-9699
Mailing Address - Fax:630-482-9669
Practice Address - Street 1:528 S BATAVIA AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2921
Practice Address - Country:US
Practice Address - Phone:630-482-9699
Practice Address - Fax:630-482-9669
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.014372104100000X
IL149.0175051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker