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NPI Code Detail

MEDICARE: DOUGLAS ALAN MEGENHARDT

MEDICARE: DOUGLAS ALAN MEGENHARDT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1952937757
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS ALAN MEGENHARDT
Provider Business Mailing Address
First Line : 631 MARGUERITE AVE
Second Line :
City : CUYAHOGA FALLS
State : OH
Zip : 44221-1929
Country : US
Telephone Number : 330-322-4765
Fax Number :
Provider Business Practice Location Address
First Line : 205 WADSWORTH RD
Second Line :
City : WADSWORTH
State : OH
Zip : 44281-9580
Country : US
Telephone Number : 234-217-8882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2020
Last Update Date : 03/12/2020

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Directions to “ DOUGLAS ALAN MEGENHARDT ” Practice Location

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