MEDICARE: NICOLE MEEHAN LCADC

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	37LC00415600	NJ

General Provider Information

NPI Number	:	1881545002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MEEHAN LCADC

Provider Business Mailing Address
First Line	:	600 N VICTORIA AVE
Second Line	:	APT B
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406
Country	:	US
Telephone Number	:	609-742-2887
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N VICTORIA AVE
Second Line	:	APT B
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406
Country	:	US
Telephone Number	:	609-742-2887
Fax Number	:

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

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “ NICOLE MEEHAN LCADC” Practice Location

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