Healthcare Provider Details

I. General information

NPI: 1124661673
Provider Name (Legal Business Name): MEGAN ELIZABETH VON DOLLEN LMHC-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN VONDOLLEN LMHC-D

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 BROADWAY
RENSSELAER NY
12144-2602
US

IV. Provider business mailing address

321 BROADWAY
RENSSELAER NY
12144-2602
US

V. Phone/Fax

Practice location:
  • Phone: 518-453-2280
  • Fax: 518-453-2282
Mailing address:
  • Phone: 518-453-2280
  • Fax: 518-453-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: