Provider Demographics
NPI:1245723337
Name:MCFAIL, WILLIAM T (PLPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:MCFAIL
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 STATE HWY KK
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065
Mailing Address - Country:US
Mailing Address - Phone:573-302-7241
Mailing Address - Fax:573-302-7239
Practice Address - Street 1:1191 STATE HWY KK
Practice Address - Street 2:SUITE 101
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065
Practice Address - Country:US
Practice Address - Phone:573-302-7241
Practice Address - Fax:573-302-7239
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018033176101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherNO OTHER IDENTIFIER