MEDICARE: MEGAN ELAINE LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1891646063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGAN ELAINE LLC

Provider Business Mailing Address
First Line	:	1943 E OVERLAND RD STE 100D
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6762
Country	:	US
Telephone Number	:	667-786-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	1943 E OVERLAND RD STE 100D
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6762
Country	:	US
Telephone Number	:	667-786-4040
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MEGAN ELAINE
Credential	:	LCSW
Telephone Number	:	667-786-4040

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	03/03/2026

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Directions to “MEGAN ELAINE LLC ” Practice Location

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