MEDICARE: MEGAN NOLAN 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	088831-01	NY

General Provider Information

NPI Number	:	1821443144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN NOLAN LCSW

Provider Business Mailing Address
First Line	:	70 GLEN COVE RD STE LL3
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1722
Country	:	US
Telephone Number	:	516-971-3468
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD STE LL3
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1722
Country	:	US
Telephone Number	:	516-971-3468
Fax Number	:

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

Provider Enumeration Date	:	04/25/2016
Last Update Date	:	11/25/2019

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