Provider Demographics
NPI:1699887794
Name:MCGEE, ABIGAIL MEG (PCC-S)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MEG
Last Name:MCGEE
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-1744
Mailing Address - Country:US
Mailing Address - Phone:740-577-7737
Mailing Address - Fax:740-577-3050
Practice Address - Street 1:287 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1744
Practice Address - Country:US
Practice Address - Phone:740-577-7737
Practice Address - Fax:740-577-3050
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0700260 SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3343Medicare ID - Type Unspecified
SC405127Medicaid