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NPI Code Detail

MEDICARE: MEGAN RIDLE LPC, CADC-I

MEDICARE: MEGAN RIDLE LPC, CADC-I
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
1101YA0400XAddiction (Substance Use Disorder) Counselor10-09-46OR
2171M00000XCase Manager/Care Coordinator
3101YM0800XMental Health CounselorC3464OR

General Provider Information

NPI Number : 1841448396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN RIDLE LPC, CADC-I
Provider Business Mailing Address
First Line : 1975 MCPHERSON ST,
Second Line : STE, 200
City : NORTH BEND
State : OR
Zip : 97459
Country : US
Telephone Number : 541-751-2505
Fax Number : 541-751-2661
Provider Business Practice Location Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6700
Fax Number : 541-888-8726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2008
Last Update Date : 07/09/2019

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