MEDICARE: MRS. MEGAN ELLEN PAOLINO LCSW

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	CW019067	PA

General Provider Information

NPI Number	:	1750836771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN ELLEN PAOLINO LCSW

Provider Business Mailing Address
First Line	:	711B 3RD AVE S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-3259
Country	:	US
Telephone Number	:	267-247-6504
Fax Number	:

Provider Business Practice Location Address
First Line	:	711B 3RD AVE S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-3259
Country	:	US
Telephone Number	:	267-247-6504
Fax Number	:

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	06/20/2024

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