Provider Demographics
NPI:1588029136
Name:GARZA, MEGAN RAE (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RAE
Last Name:GARZA
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:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82411-0152
Mailing Address - Country:US
Mailing Address - Phone:623-688-7900
Mailing Address - Fax:
Practice Address - Street 1:710 LANE 39
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WY
Practice Address - Zip Code:82411-9739
Practice Address - Country:US
Practice Address - Phone:623-688-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2025-08-23
Deactivation Date:2018-05-17
Deactivation Code:
Reactivation Date:2021-08-28
Provider Licenses
StateLicense IDTaxonomies
AZ206731041C0700X
TX1139361041C0700X
MI68011188491041C0700X
WY13341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty