Provider Demographics
NPI:1932406931
Name:MCINTOSH, MICHAEL LAD (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAD
Last Name:MCINTOSH
Suffix:
Gender:M
Credentials:PSYD
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 523
Mailing Address - Street 2:
Mailing Address - City:DILLSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28725-0523
Mailing Address - Country:US
Mailing Address - Phone:828-371-3710
Mailing Address - Fax:
Practice Address - Street 1:303 KING FISHER LN
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-7714
Practice Address - Country:US
Practice Address - Phone:828-371-3710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist