Provider Demographics
NPI:1780325738
Name:WHEELER, MEGAN ROSE IRENE (MA, LCPC, MFLC)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE IRENE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MA, LCPC, MFLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-1301
Mailing Address - Country:US
Mailing Address - Phone:406-577-6712
Mailing Address - Fax:
Practice Address - Street 1:32 S EWING ST STE 314
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5750
Practice Address - Country:US
Practice Address - Phone:406-577-6712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-55427101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health