Provider Demographics
NPI:1699265470
Name:MEGAN GINGO COUNSELING, PLLC
Entity type:Organization
Organization Name:MEGAN GINGO COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GINGO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:312-330-8416
Mailing Address - Street 1:3340 REPUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4154
Mailing Address - Country:US
Mailing Address - Phone:612-444-1740
Mailing Address - Fax:
Practice Address - Street 1:3340 REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4154
Practice Address - Country:US
Practice Address - Phone:612-444-1740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN21659261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)