Provider Demographics
NPI:1548937444
Name:BROSNAN, MEAGHAN ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ELIZABETH
Last Name:BROSNAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BROADWAY STE 2130
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3733
Mailing Address - Country:US
Mailing Address - Phone:929-320-6105
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY STE 2130
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3733
Practice Address - Country:US
Practice Address - Phone:929-320-6105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088967104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker