Provider Demographics
NPI:1871897199
Name:SIGMON-OLSEN, MEGAN L (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:SIGMON-OLSEN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 CLEVELAND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1218
Mailing Address - Country:US
Mailing Address - Phone:763-913-8261
Mailing Address - Fax:763-210-5221
Practice Address - Street 1:670 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1218
Practice Address - Country:US
Practice Address - Phone:763-913-8261
Practice Address - Fax:763-210-5221
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN197481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical