Provider Demographics
NPI:1396527552
Name:MEGAN GERAK MSW LLC
Entity type:Organization
Organization Name:MEGAN GERAK MSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:GERAK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:218-398-0988
Mailing Address - Street 1:502 NE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-2820
Mailing Address - Country:US
Mailing Address - Phone:218-250-8687
Mailing Address - Fax:218-203-4782
Practice Address - Street 1:10 NW 5TH ST STE 3
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-2758
Practice Address - Country:US
Practice Address - Phone:218-250-8687
Practice Address - Fax:218-203-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health