Provider Demographics
NPI:1063171080
Name:FOLEY, MEGAN JUSTINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:JUSTINA
Last Name:FOLEY
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 1:4627 FINLEY AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6603
Mailing Address - Country:US
Mailing Address - Phone:213-291-5534
Mailing Address - Fax:
Practice Address - Street 1:4627 FINLEY AVE APT 306
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6603
Practice Address - Country:US
Practice Address - Phone:213-291-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA948811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical