MEDICARE: MEGAN COOK RALEIGH

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	1041C0700X	Clinical Social Worker
4	1041C0700X	Clinical Social Worker	I.1500294	OH

General Provider Information

NPI Number	:	1881054211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN COOK RALEIGH

Provider Business Mailing Address
First Line	:	41452 OBERLIN ELYRIA RD
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-7544
Country	:	US
Telephone Number	:	216-965-6361
Fax Number	:	216-965-6361

Provider Business Practice Location Address
First Line	:	1215 W 3RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1532
Country	:	US
Telephone Number	:	216-965-6361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2016
Last Update Date	:	07/11/2025

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