Healthcare Provider Details

I. General information

NPI: 1972995025
Provider Name (Legal Business Name): JOSEPH MCMAHAN LMHC, MA, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 W 12TH ST STE 205
PERU IN
46970-1654
US

IV. Provider business mailing address

240 N TILLOTSON AVE
MUNCIE IN
47304-3988
US

V. Phone/Fax

Practice location:
  • Phone: 765-472-5335
  • Fax:
Mailing address:
  • Phone: 765-288-1928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87001562A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002810A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: