Provider Demographics
NPI:1104649359
Name:MEGAN CROWNINGSHIELD LCSW
Entity type:Organization
Organization Name:MEGAN CROWNINGSHIELD LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWNINGSHIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-790-5288
Mailing Address - Street 1:2904 BATTLE MOUNTAIN WAY APT C
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-8005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2904 BATTLE MOUNTAIN WAY APT C
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-8005
Practice Address - Country:US
Practice Address - Phone:850-790-5288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty