=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427338599
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JIM MCGAHA & ASSOCIATES,INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2011
-----------------------------------------------------
Last Update Date | 01/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 MOTOR INN DR STE 110
-----------------------------------------------------
City | GIRARD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44420-2481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-744-2468
-----------------------------------------------------
Fax | 330-744-2586
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1601 MOTOR INN DR STE 110
-----------------------------------------------------
City | GIRARD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44420-2481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-744-2468
-----------------------------------------------------
Fax | 330-744-2586
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. JIM M MCGAHA
-----------------------------------------------------
Credential | LPPC-S LICDC
-----------------------------------------------------
Telephone | 330-744-2468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | C-0501116
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------