Provider Demographics
NPI:1144927179
Name:NICHOLAS, MEGAN FALVEY (LADC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:FALVEY
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COMO AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1818
Mailing Address - Country:US
Mailing Address - Phone:612-267-3007
Mailing Address - Fax:
Practice Address - Street 1:2200 E FRANKLIN AVE STE 200A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2395
Practice Address - Country:US
Practice Address - Phone:612-874-9811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)