Healthcare Provider Details

I. General information

NPI: 1881404291
Provider Name (Legal Business Name): MEGAN MARCINOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 W MAIN ST FL 2
ASHLAND OH
44805-2218
US

IV. Provider business mailing address

1232 KING RD
ASHLAND OH
44805-3633
US

V. Phone/Fax

Practice location:
  • Phone: 440-782-1076
  • Fax:
Mailing address:
  • Phone: 567-215-3304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2606742
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: