Provider Demographics
NPI:1346915733
Name:HESS, MEGAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HESS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E 20TH ST UNIT 5526
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-7185
Mailing Address - Country:US
Mailing Address - Phone:505-578-8447
Mailing Address - Fax:
Practice Address - Street 1:2120 SULLIVAN AVE # 25
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4324
Practice Address - Country:US
Practice Address - Phone:505-578-8447
Practice Address - Fax:505-485-0569
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-11342104100000X
NMSWB-2024-07381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker