Provider Demographics
NPI:1386537652
Name:BOTELLO, MEAGAN (BA, MS, PLMHP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:BOTELLO
Suffix:
Gender:F
Credentials:BA, MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST STE 506
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2945
Mailing Address - Country:US
Mailing Address - Phone:402-788-4846
Mailing Address - Fax:
Practice Address - Street 1:1941 S 42ND ST STE 506
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2945
Practice Address - Country:US
Practice Address - Phone:402-788-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health