Provider Demographics
NPI:1487237764
Name:KNIFFEN, MEGAN MALINDA (LCSW-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MALINDA
Last Name:KNIFFEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MALINDA
Other - Last Name:RAWLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2512 CHELMSFORD DR
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1677
Mailing Address - Country:US
Mailing Address - Phone:301-502-8331
Mailing Address - Fax:
Practice Address - Street 1:2512 CHELMSFORD DR
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1677
Practice Address - Country:US
Practice Address - Phone:301-502-8331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical