MEDICARE: MEGAN MARIE RADOSEVICH MA, LPCC

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	CC01347	MN

General Provider Information

NPI Number	:	1235671306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARIE RADOSEVICH MA, LPCC

Provider Business Mailing Address
First Line	:	2056 SCOTT RD NW STE 100
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-4518
Country	:	US
Telephone Number	:	507-398-3394
Fax Number	:

Provider Business Practice Location Address
First Line	:	2056 SCOTT RD NW STE 100
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-4518
Country	:	US
Telephone Number	:	507-398-3394
Fax Number	:

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

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	06/01/2026

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