Provider Demographics
NPI:1093258808
Name:WEXLER, MEGAN REGINA (MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:REGINA
Last Name:WEXLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1335
Mailing Address - Country:US
Mailing Address - Phone:605-339-0420
Mailing Address - Fax:605-339-0038
Practice Address - Street 1:1200 N WEST AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1335
Practice Address - Country:US
Practice Address - Phone:605-339-0420
Practice Address - Fax:605-339-0038
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD48841041C0700X, 1041C0700X
NE18951041C0700X
NE23461041C0700X
MN273731041C0700X
IA0913181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1093258808Medicaid