Provider Demographics
NPI:1346089158
Name:BITTICK, MEGAN LEIGH (LMSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:BITTICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 COUNTY ROAD 2788
Mailing Address - Street 2:
Mailing Address - City:ALVORD
Mailing Address - State:TX
Mailing Address - Zip Code:76225-3355
Mailing Address - Country:US
Mailing Address - Phone:940-210-0204
Mailing Address - Fax:
Practice Address - Street 1:2000 HIGHLAND VILLAGE RD STE C
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-8105
Practice Address - Country:US
Practice Address - Phone:972-861-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108416104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker