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NPI Code Detail

MEDICARE: MRS. MEGAN VITALE LCSW

MEDICARE: MRS. MEGAN VITALE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
21041C0700XClinical Social Worker2001000521MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001932396OTHERMODEPARTMENT OF SOCIAL SERV
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3177040OTHERMOBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1033163613
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN VITALE LCSW
Provider Business Mailing Address
First Line : 227 MAIN ST
Second Line :
City : FESTUS
State : MO
Zip : 63028-1952
Country : US
Telephone Number : 636-931-2700
Fax Number : 636-931-5304
Provider Business Practice Location Address
First Line : 21 MUNICIPAL DR
Second Line :
City : ARNOLD
State : MO
Zip : 63010-1012
Country : US
Telephone Number : 636-296-6206
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 06/06/2023

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Directions to “ MRS. MEGAN VITALE LCSW” Practice Location

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