Provider Demographics
NPI:1366185266
Name:PRITCHARD, MEGAN RENA (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENA
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENA
Other - Last Name:MANSFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3021 SENNA DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:704-443-0144
Mailing Address - Fax:704-476-1331
Practice Address - Street 1:3021 SENNA DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:704-443-0144
Practice Address - Fax:704-476-1331
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0150071041C0700X
WALW612028941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical