MEDICARE: MEGAN POLM

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	1055	NE
2	101YM0800X	Mental Health Counselor	4412	NE

General Provider Information

NPI Number	:	1861270142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN POLM

Provider Business Mailing Address
First Line	:	18707 WASHINGTON ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-3176
Country	:	US
Telephone Number	:	402-972-5593
Fax Number	:

Provider Business Practice Location Address
First Line	:	1299 FARNAM ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68102-1880
Country	:	US
Telephone Number	:	323-676-1233
Fax Number	:

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

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	01/26/2026

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Directions to “ MEGAN POLM ” Practice Location

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