MEDICARE: MEGAN ESTREM LMSW

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	101YM0800X	Mental Health Counselor	LMSW-20019	AZ

General Provider Information

NPI Number	:	1902665185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ESTREM LMSW

Provider Business Mailing Address
First Line	:	1313 N 2ND ST APT 1214
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 N 2ND ST APT 1214
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1766
Country	:	US
Telephone Number	:	847-772-9620
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	03/18/2024

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Directions to “ MEGAN ESTREM LMSW” Practice Location

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