Provider Demographics
NPI:1518524396
Name:MCGAHA, COLTER CLELAND (LPC)
Entity Type:Individual
Prefix:MR
First Name:COLTER
Middle Name:CLELAND
Last Name:MCGAHA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 MEMORIAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5374
Mailing Address - Country:US
Mailing Address - Phone:256-850-4091
Mailing Address - Fax:256-970-1643
Practice Address - Street 1:3315 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5374
Practice Address - Country:US
Practice Address - Phone:256-850-4091
Practice Address - Fax:256-970-1643
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
AZC3153A101Y00000X
AL4429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL330000014Medicaid