Provider Demographics
NPI:1750836771
Name:PAOLINO, MEGAN ELLEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELLEN
Last Name:PAOLINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711B 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3259
Mailing Address - Country:US
Mailing Address - Phone:267-247-6504
Mailing Address - Fax:
Practice Address - Street 1:711B 3RD AVE S
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3259
Practice Address - Country:US
Practice Address - Phone:267-247-6504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0190671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical