MEDICARE: MEGAN MCCARTNEY MSW

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	101YM0800X	Mental Health Counselor	0108128	CO

General Provider Information

NPI Number	:	1104325935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MCCARTNEY MSW

Provider Business Mailing Address
First Line	:	193 HERMOSA CIR
Second Line	:
City	:	DURANGO
State	:	CO
Zip	:	81301-3903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 COLORADO AVE UNIT 2A
Second Line	:
City	:	DURANGO
State	:	CO
Zip	:	81301-4761
Country	:	US
Telephone Number	:	847-445-2777
Fax Number	:

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

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	02/07/2018

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