Provider Demographics
NPI:1316432958
Name:MARTIN, MEGAN MICHELLE (PCMSW, PLMHP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MICHELLE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PCMSW, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 CENTRAL PARK DR # 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3461
Mailing Address - Country:US
Mailing Address - Phone:402-802-4924
Mailing Address - Fax:402-477-0081
Practice Address - Street 1:5001 CENTRAL PARK DR # 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3461
Practice Address - Country:US
Practice Address - Phone:402-802-4924
Practice Address - Fax:402-477-0081
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72391041C0700X
NE11447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical