Provider Demographics
NPI:1952173619
Name:MCGLOWN, JOHN EDWARD JR (ALC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:MCGLOWN
Suffix:JR
Gender:M
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-9275
Mailing Address - Country:US
Mailing Address - Phone:334-798-1259
Mailing Address - Fax:
Practice Address - Street 1:201 ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:HEADLAND
Practice Address - State:AL
Practice Address - Zip Code:36345-9275
Practice Address - Country:US
Practice Address - Phone:334-798-1259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC02367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health