Healthcare Provider Details

I. General information

NPI: 1275144784
Provider Name (Legal Business Name): ABIGAIL F MCGOHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 BROOKS INDUSTRIAL RD
SHELBYVILLE KY
40065-8154
US

IV. Provider business mailing address

5000 LIBBIE MILL EAST BLVD APT 130
RICHMOND VA
23230-2159
US

V. Phone/Fax

Practice location:
  • Phone: 502-633-1315
  • Fax:
Mailing address:
  • Phone: 502-264-2816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: