Provider Demographics
NPI:1588923163
Name:LAYBOURN, MEGHAN BURKE (MSW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:BURKE
Last Name:LAYBOURN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:CURRAN
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 ABBEY STREET
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050
Mailing Address - Country:US
Mailing Address - Phone:631-745-1242
Mailing Address - Fax:
Practice Address - Street 1:42 ABBEY ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2689
Practice Address - Country:US
Practice Address - Phone:631-745-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA116981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health