Provider Demographics
NPI:1386279883
Name:FARAONE, MEAGAN M (LCSW)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:M
Last Name:FARAONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:MARY
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:167 1ST ST
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-4305
Mailing Address - Country:US
Mailing Address - Phone:304-209-4608
Mailing Address - Fax:
Practice Address - Street 1:167 1ST ST
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-4305
Practice Address - Country:US
Practice Address - Phone:304-209-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0122431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical