Healthcare Provider Details

I. General information

NPI: 1962242818
Provider Name (Legal Business Name): MEGAN ROSENBERG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 EAGLE DR NE
MOSES LAKE WA
98837-9166
US

IV. Provider business mailing address

PO BOX 66
MOSES LAKE WA
98837-0007
US

V. Phone/Fax

Practice location:
  • Phone: 406-369-7700
  • Fax:
Mailing address:
  • Phone: 406-369-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MEGAN ELIZABETH ROSENBERG
Title or Position: CLINICAL PROFESSIONAL COUNSELOR
Credential: LCPC
Phone: 509-793-3075