Provider Demographics
NPI:1255941183
Name:ANGSTADT, MEGAN (LSIW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ANGSTADT
Suffix:
Gender:X
Credentials:LSIW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 SAINT JOHNS TER
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3043
Mailing Address - Country:US
Mailing Address - Phone:740-972-4938
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-221-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2405096104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker