Provider Demographics
NPI:1447693478
Name:HARDEN, MEGAN L (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:HARDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:SUZANNE
Other - Last Name:CHETELAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:948 ELM ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2277
Mailing Address - Country:US
Mailing Address - Phone:270-266-1188
Mailing Address - Fax:270-908-2880
Practice Address - Street 1:948 ELM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2277
Practice Address - Country:US
Practice Address - Phone:270-266-1188
Practice Address - Fax:270-908-2880
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY64181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100321420Medicaid
KYK184810Medicare PIN