Provider Demographics
NPI:1104394675
Name:ARELLANO, MEGHAN NORA (BA-CSCAD)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:NORA
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:BA-CSCAD
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:NORA
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3420
Mailing Address - Country:US
Mailing Address - Phone:240-278-7494
Mailing Address - Fax:
Practice Address - Street 1:2610 GREENBRIAR LN
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4424
Practice Address - Country:US
Practice Address - Phone:240-278-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC2337101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)