1316771678 NPI number — MRS. MEGAN DIANE CLINGERMAN LCSW

Table of content: MRS. MEGAN DIANE CLINGERMAN LCSW (NPI 1316771678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316771678 NPI number — MRS. MEGAN DIANE CLINGERMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLINGERMAN
Provider First Name:
MEGAN
Provider Middle Name:
DIANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WATSON
Provider Other First Name:
MEGAN
Provider Other Middle Name:
DIANE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316771678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1209 MONTGOMERY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19034-1515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-840-1127
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1209 MONTGOMERY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19034-1515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-840-1127
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW021466 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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