Provider Demographics
NPI:1285235192
Name:MACCLEARY, MEAGAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:MACCLEARY
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 1:13418 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6054
Mailing Address - Country:US
Mailing Address - Phone:480-262-4371
Mailing Address - Fax:
Practice Address - Street 1:2509 S POWER RD STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6696
Practice Address - Country:US
Practice Address - Phone:480-389-6018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18986101Y00000X
AZLCSW-216301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor