Basic Information
| Provider Information | |||||||||
| NPI: | 1487084539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEINWAGNER | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MORIARTY-STEINWAGNER | ||||||||
| OtherFirstName: | MEGAN | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 25 LAKE DRIVE | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326841922 | ||||||||
| FaxNumber: | 7328979541 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 LAKE DRIVE | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326841922 | ||||||||
| FaxNumber: | 7328979541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2013 | ||||||||
| LastUpdateDate: | 09/16/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 44L05782200 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.