Provider Demographics
NPI:1588090377
Name:GOLDFARB, MEGAN ANNE (MA CI)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ANNE
Last Name:GOLDFARB
Suffix:
Gender:F
Credentials:MA CI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 TCHOUPITOULAS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2023
Mailing Address - Country:US
Mailing Address - Phone:832-525-5384
Mailing Address - Fax:
Practice Address - Street 1:1125 N TONTI ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3549
Practice Address - Country:US
Practice Address - Phone:504-821-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACI5726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional