Provider Demographics
NPI:1033364724
Name:MCGHEE, MATTHEW CLEM (MS, LCPC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CLEM
Last Name:MCGHEE
Suffix:
Gender:M
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2832
Mailing Address - Country:US
Mailing Address - Phone:620-231-1708
Mailing Address - Fax:
Practice Address - Street 1:710 W 8TH ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-2404
Practice Address - Country:US
Practice Address - Phone:620-223-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007025935101YP2500X
KSLCPC780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional