MEDICARE: MEGAN MARDO MA

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	MHC00740	RI
2	101YM0800X	Mental Health Counselor	LMHC10005742	MA

General Provider Information

NPI Number	:	1205177342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARDO MA

Provider Business Mailing Address
First Line	:	9 SHARON DR
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-6109
Country	:	US
Telephone Number	:	908-910-3561
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 SHARON DR
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-6109
Country	:	US
Telephone Number	:	908-910-3561
Fax Number	:

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

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	03/12/2026

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