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General NPI Number Information
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NPI Number | 1962216770
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Entity Type | Organization
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Legal Business Name | MEGAN EBENGER
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 824 E BROAD ST STE A
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City | ELYRIA
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State | OH
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Zip | 44035-6559
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Country | US
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Telephone | 216-452-7110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 38011
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City | OLMSTED FALLS
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State | OH
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Zip | 44138-0011
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Country | US
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Telephone | 216-452-7110
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Fax |
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Authorized Official
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Title or Position | CLINICAL MENTAL HEALTH THERAPIST
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Name | MEGAN EBENGER
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Credential | LPCC-S
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Telephone | 216-452-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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