Healthcare Provider Details
I. General information
NPI: 1174157846
Provider Name (Legal Business Name): ALMETA ANNE MCGLOTHLIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/02/2020
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
411 CRAB ORCHARD RD
SOMERSET KY
42503-1349
US
IV. Provider business mailing address
411 CRAB ORCHARD RD
SOMERSET KY
42503-1349
US
V. Phone/Fax
- Phone: 606-305-5829
- Fax:
- Phone: 606-485-4673
- Fax: 606-485-4600
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 252392 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 254703 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: