Provider Demographics
NPI:1275209322
Name:HALL, MEGAN ANN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:GRIBBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16504 9TH AVE SE STE 106
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6388
Mailing Address - Country:US
Mailing Address - Phone:425-510-0168
Mailing Address - Fax:425-491-4609
Practice Address - Street 1:16504 9TH AVE SE STE 106
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-6388
Practice Address - Country:US
Practice Address - Phone:425-510-0168
Practice Address - Fax:425-491-4609
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW608771351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical