MEDICARE: MEGAN EBENGER

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

General Provider Information

NPI Number	:	1962216770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGAN EBENGER

Provider Business Mailing Address
First Line	:	PO BOX 38011
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-0011
Country	:	US
Telephone Number	:	216-452-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 E BROAD ST STE A
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-6559
Country	:	US
Telephone Number	:	216-452-7110
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL MENTAL HEALTH THERAPIST
Name	:	MEGAN EBENGER
Credential	:	LPCC-S
Telephone Number	:	216-452-7110

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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