MEDICARE: EMILIA T MCGLOIN LMHC

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	101YM0800X	Mental Health Counselor	012824-01	NY
2	101YM0800X	Mental Health Counselor	0704007458

General Provider Information

NPI Number	:	1689201394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILIA T MCGLOIN LMHC

Provider Business Mailing Address
First Line	:	2055 STRAIGHT FORK ZEKES BRANCH RD
Second Line	:
City	:	BOONEVILLE
State	:	KY
Zip	:	41314-7434
Country	:	US
Telephone Number	:	646-263-1022
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 STRAIGHT FORK ZEKES BRANCH RD
Second Line	:
City	:	BOONEVILLE
State	:	KY
Zip	:	41314-7434
Country	:	US
Telephone Number	:	646-263-1022
Fax Number	:

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

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	12/23/2024

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