Healthcare Provider Details

I. General information

NPI: 1184533838
Provider Name (Legal Business Name): TERRY MELVIN CAVANAUGH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W SOUTH ST
MC ARTHUR OH
45651-1077
US

IV. Provider business mailing address

316 W SOUTH ST
MC ARTHUR OH
45651-1077
US

V. Phone/Fax

Practice location:
  • Phone: 740-583-7302
  • Fax:
Mailing address:
  • Phone: 740-583-7302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: