=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982351730
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOUGLAS LEE MCGAHEY LPC, NCC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2022
-----------------------------------------------------
Last Update Date | 03/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5100 LINBAR DRIVE SUITE 102
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37211-8207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-257-8457
-----------------------------------------------------
Fax | 615-807-4778
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3172 SKINNER DR
-----------------------------------------------------
City | ANTIOCH
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37013-3964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-424-2628
-----------------------------------------------------
Fax | 615-807-4778
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 2900
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------