MEDICARE: MEGAN CARRACO LCPC

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		MD
2	101YM0800X	Mental Health Counselor	LC12570	MD

General Provider Information

NPI Number	:	1437767415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN CARRACO LCPC

Provider Business Mailing Address
First Line	:	2808 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3010
Country	:	US
Telephone Number	:	214-727-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3010
Country	:	US
Telephone Number	:	214-727-4477
Fax Number	:

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

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	09/30/2024

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