Provider Demographics
NPI:1689022816
Name:SOEN, MEGAN QUARLES BAKER (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:QUARLES BAKER
Last Name:SOEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:QUARLES
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:308 STRATFORD PL APT 32
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2381
Mailing Address - Country:US
Mailing Address - Phone:630-450-4385
Mailing Address - Fax:
Practice Address - Street 1:14 HEALTH SERVICES DR
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-9637
Practice Address - Country:US
Practice Address - Phone:815-758-8616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.101423104100000X
IL1490199741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker