Provider Demographics
NPI:1619210994
Name:MCGEHEE, JAMES PITTMAN (PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PITTMAN
Last Name:MCGEHEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:PITTMAN
Other - Middle Name:
Other - Last Name:MCGEHEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:508 DEEP EDDY AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4555
Mailing Address - Country:US
Mailing Address - Phone:512-236-1760
Mailing Address - Fax:512-469-0889
Practice Address - Street 1:508 DEEP EDDY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4555
Practice Address - Country:US
Practice Address - Phone:512-236-1760
Practice Address - Fax:512-469-0889
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36398103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling