Provider Demographics
NPI:1952937419
Name:SANTIAGO, MEAGAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:SANTIAGO
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 1:9459 FOREST HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7671
Mailing Address - Country:US
Mailing Address - Phone:813-431-4954
Mailing Address - Fax:
Practice Address - Street 1:9459 FOREST HILLS CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7671
Practice Address - Country:US
Practice Address - Phone:813-431-4954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW189251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical