Individual provider Active NPI

Megan Marie Poliquin, LPCC, LICDC-GAMB

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1760965123
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2203139 Issued in OH
Practice address
2005 Ashland Ave
Toledo, OH 43620-1703
Phone
(419) 841-7701
NPI assigned
Sep 12, 2018
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162051 OH
Mental Health Counselor 101YM0800X C.1801338 OH
Professional Counselor 101YP2500X E.2203139 OH Primary

Addresses

Primary practice location

2005 Ashland Ave
Toledo, OH 43620-1703

Mailing address

2005 Ashland Ave
Toledo, OH 43620-1703
Phone (419) 841-7701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201004120 OH Practitioner - Mental Health Counselor 0547613861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Toledo College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zepf CenterGroup PAC ID 5395639215, 43 clinicians

Practice addresses (Care Compare)

2005 Ashland Ave
Toledo, OH 43620-1703
Phone (419) 841-7701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.162051OHMDAddiction (Substance Use Disorder) Counselor
C.1801338OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Zepf Center CurrentSince Jan 1, 2024 Accepting new patients
Zepf Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

2005 Ashland Ave
Toledo, OH 43620
Phone (419) 255-3040

6605 W Central Ave
Ste 100
Toledo, OH 43617
Phone 41984177012235

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1760965123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703",
            "telephone_number": "419-841-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703",
            "telephone_number": "419-841-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIQUIN",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "LPCC, LICDC-GAMB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162051",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1801338",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2203139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.