Provider Demographics
NPI:1558499244
Name:MCCANN, WILLIAM GERALD
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GERALD
Last Name:MCCANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 TUTOR LN
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-4220
Mailing Address - Country:US
Mailing Address - Phone:931-796-1389
Mailing Address - Fax:
Practice Address - Street 1:912 SUMMERTOWN HWY
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-5703
Practice Address - Country:US
Practice Address - Phone:931-796-5916
Practice Address - Fax:931-796-1288
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
37104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker