MEDICARE: MEGAN LYNNE HOLDEN LMSW

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
1	106S00000X	Behavior Technician
2	104100000X	Social Worker	SWB-2024-0579	NM

General Provider Information

NPI Number	:	1033683289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LYNNE HOLDEN LMSW

Provider Business Mailing Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 260
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2160
Country	:	US
Telephone Number	:	505-226-2839
Fax Number	:	505-295-2559

Provider Business Practice Location Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 260
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2160
Country	:	US
Telephone Number	:	505-226-2839
Fax Number	:	505-295-2559

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2019
Last Update Date	:	03/26/2026

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