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NPI Code Detail

MEDICARE: MEGAN ELIZABETH TREZIOK MPS, LADC, LPCC

MEDICARE:   MEGAN ELIZABETH TREZIOK  MPS, LADC, LPCC
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) Counselor305820MN
2101YM0800XMental Health Counselor
3101YM0800XMental Health Counselor03895MN

General Provider Information

NPI Number : 1992398960
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN ELIZABETH TREZIOK MPS, LADC, LPCC
Provider Business Mailing Address
First Line : 543 GOTZIAN ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-5333
Country : US
Telephone Number : 612-237-4767
Fax Number :
Provider Business Practice Location Address
First Line : 701 4TH AVE S STE 1500
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1637
Country : US
Telephone Number : 612-373-9164
Fax Number : 612-373-2470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2021
Last Update Date : 08/08/2023

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