Provider Demographics
NPI:1053136168
Name:RYAN, MEGAN (MSW, MED, LSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:MSW, MED, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SANSOM ST FL 11
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5245
Mailing Address - Country:US
Mailing Address - Phone:215-563-7863
Mailing Address - Fax:
Practice Address - Street 1:1700 SANSOM ST FL 11
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5245
Practice Address - Country:US
Practice Address - Phone:215-563-7863
Practice Address - Fax:215-563-5815
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141721104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker