MEDICARE: EILEEN L. MCGEE LPC, LADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	14	OK
2	101YM0800X	Mental Health Counselor	2322	OK

General Provider Information

NPI Number	:	1669515201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN L. MCGEE LPC, LADC

Provider Business Mailing Address
First Line	:	312 N MAIN ST
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4237
Country	:	US
Telephone Number	:	580-225-7930
Fax Number	:	580-225-7930

Provider Business Practice Location Address
First Line	:	100 S MONROE ST STE 15
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-5762
Country	:	US
Telephone Number	:	580-303-0527
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	03/16/2009

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