Provider Demographics
NPI:1962879098
Name:CO, MEGHAN (LCSW-C, LICSW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:CO
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CENTER DRIVE MSC 1160, BUILDING 10-CRC ROOM 2-3581
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:202-643-5804
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR MSC 1160, BUILDING 10-CRC ROOM 2-3581
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1002
Practice Address - Country:US
Practice Address - Phone:202-643-5804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2023-12-04
Deactivation Date:2022-08-05
Deactivation Code:
Reactivation Date:2023-08-02
Provider Licenses
StateLicense IDTaxonomies
DCLC500819851041C0700X
MD233951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical