Provider Information for 1427539840
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MEGAN ERIIKA SHIPLEY LCSW
Other Names:Former Name:MEGAN ERIIKA BERGSTEDTSex: Female
NPI: 1427539840
Last Updated: 2021-10-18
Certification Date: 2021-10-18
Certification Date: 2021-10-18
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1427539840 | ||||||||||||
| Enumeration Date | 2018-08-23 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2222 E 5TH ST SUPERIOR, WI 54880-3709 United States Phone: 715-395-5393 | Fax:715-392-1935 | ||||||||||||
| Primary Practice Address | 2222 E 5TH ST SUPERIOR, WI 54880-3709 United States Phone: 715-392-1955 | Fax:715-392-1935 | ||||||||||||
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