Provider Demographics
NPI:1275156473
Name:RELSON, MEGAN ROSE (MSED, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ROSE
Last Name:RELSON
Suffix:
Gender:F
Credentials:MSED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 MCKINLEY ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2333
Mailing Address - Country:US
Mailing Address - Phone:651-323-0795
Mailing Address - Fax:
Practice Address - Street 1:3111 MCKINLEY ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-2333
Practice Address - Country:US
Practice Address - Phone:651-323-0795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional