MEDICARE: MEGAN WOLFF COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1568056620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGAN WOLFF COUNSELING

Provider Business Mailing Address
First Line	:	11605 W DODGE RD STE 4
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2566
Country	:	US
Telephone Number	:	402-515-4140
Fax Number	:

Provider Business Practice Location Address
First Line	:	11605 W DODGE RD STE 4
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-2566
Country	:	US
Telephone Number	:	402-515-4140
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN M WOLFF
Credential	:	LMHP, PLADC
Telephone Number	:	402-515-4140

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	03/01/2021

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