MEDICARE: METZGERS MYNDFUL MOMENTS

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1669157392	OTHER	NV	GROUP TYPE 2 NPI
2	1740535749	OTHER	NV	PERSONAL TYPE 1 NPI

General Provider Information

NPI Number	:	1669157392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METZGERS MYNDFUL MOMENTS

Provider Business Mailing Address
First Line	:	1005 TERMINAL WAY STE 172
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-2179
Country	:	US
Telephone Number	:	775-600-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 TERMINAL WAY STE 172
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-2179
Country	:	US
Telephone Number	:	775-600-2121
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MORGAN METZGER
Credential	:	LCSW
Telephone Number	:	775-600-2121

Provider Enumeration Date	:	06/20/2023
Last Update Date	:	05/29/2026

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