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General NPI Number Information
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NPI Number | 1629588447
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Entity Type | Individual
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Provider Name | MEGAN GIACOLETTO LMSW, CAADC
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Gender | Female
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 3539 1ST STREET
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City | MOHAWK
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State | MI
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Zip | 49950-0219
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Country | US
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Telephone | 906-369-1325
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 219
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City | MOHAWK
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State | MI
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Zip | 49950-0219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-04326
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801100240
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801109333
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License Number State | MI
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