Provider Demographics
NPI:1083880579
Name:BILLYE MCGAHARN, PSYCHOTHERAPIST CENTER, LLC
Entity Type:Organization
Organization Name:BILLYE MCGAHARN, PSYCHOTHERAPIST CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:C 'BILLYE'
Authorized Official - Last Name:MCGAHARN
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:301-475-2020
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-0604
Mailing Address - Country:US
Mailing Address - Phone:301-475-2020
Mailing Address - Fax:301-475-2102
Practice Address - Street 1:22660 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650
Practice Address - Country:US
Practice Address - Phone:301-475-2020
Practice Address - Fax:301-475-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402653500Medicaid