Healthcare Provider Details

I. General information

NPI: 1508394875
Provider Name (Legal Business Name): MEAGAN HELMHOLDT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGAN GREY

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HALL ST
TRAVERSE CITY MI
49684-2288
US

IV. Provider business mailing address

105 HALL ST
TRAVERSE CITY MI
49684-2288
US

V. Phone/Fax

Practice location:
  • Phone: 231-922-4850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802089541
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801105566
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801101474
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: