Provider Demographics
NPI:1588975858
Name:EARLEY, MEGAN M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:M
Last Name:EARLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:SELIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 E WACKER DR
Mailing Address - Street 2:SUITE 3650
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-1474
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1706 W. NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:312-213-2233
Practice Address - Fax:312-292-9377
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0142081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical