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NPI Code Detail

MEDICARE: KATIE DIANE MCGAUGHEY MSW, LSW

MEDICARE:   KATIE DIANE MCGAUGHEY  MSW, LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker3300592AIN

General Provider Information

NPI Number : 1285932442
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE DIANE MCGAUGHEY MSW, LSW
Provider Business Mailing Address
First Line : 2729 N GREEN RIVER RD
Second Line :
City : EVANSVILLE
State : IN
Zip : 47715-8010
Country : US
Telephone Number : 812-760-7756
Fax Number :
Provider Business Practice Location Address
First Line : 2729 N GREEN RIVER RD
Second Line :
City : EVANSVILLE
State : IN
Zip : 47715-8010
Country : US
Telephone Number : 812-760-7756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2011
Last Update Date : 03/11/2011

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Directions to “ KATIE DIANE MCGAUGHEY MSW, LSW” Practice Location

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