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NPI Code Detail

MEDICARE: JEANNIE MCMAHAN M.ED, LPC

MEDICARE: JEANNIE MCMAHAN M.ED, LPC
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
1101YM0800XMental Health Counselor1986OK

General Provider Information

NPI Number : 1497175368
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNIE MCMAHAN M.ED, LPC
Provider Business Mailing Address
First Line : 6402 N SANTA FE AVE
Second Line : SUITE B
City : OKLAHOMA CITY
State : OK
Zip : 73116-9118
Country : US
Telephone Number : 918-623-8121
Fax Number :
Provider Business Practice Location Address
First Line : 6402 N SANTA FE AVE
Second Line : SUITE B
City : OKLAHOMA CITY
State : OK
Zip : 73116-9118
Country : US
Telephone Number : 918-623-8121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2014
Last Update Date : 04/18/2014

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