Provider Demographics
NPI:1447527577
Name:HENNING, MEGAN E (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:HENNING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10765 LANTERN ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3597
Mailing Address - Country:US
Mailing Address - Phone:317-621-4181
Mailing Address - Fax:317-621-4182
Practice Address - Street 1:10765 LANTERN ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3597
Practice Address - Country:US
Practice Address - Phone:317-621-4181
Practice Address - Fax:317-621-4182
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006338A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN496748OtherMANAGED HEALTH NETWORK
IN000000741679OtherANTHEM
IN496748OtherMANAGED HEALTH NETWORK