MEDICARE: MEGAN CARLSON MA, LMHC

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	60696785	WA

General Provider Information

NPI Number	:	1205569209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN CARLSON MA, LMHC

Provider Business Mailing Address
First Line	:	3135 E HILLS CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-5383
Country	:	US
Telephone Number	:	971-340-6084
Fax Number	:

Provider Business Practice Location Address
First Line	:	3135 E HILLS CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-5383
Country	:	US
Telephone Number	:	971-340-6084
Fax Number	:

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

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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