Provider Demographics
NPI:1982582458
Name:MCGLON, KNEOSHA SHIRYAH (LMSW)
Entity type:Individual
Prefix:MS
First Name:KNEOSHA
Middle Name:SHIRYAH
Last Name:MCGLON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5893 HAMMERMILL LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-7126
Mailing Address - Country:US
Mailing Address - Phone:334-435-2260
Mailing Address - Fax:
Practice Address - Street 1:206 HEADLAND AVE
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-4521
Practice Address - Country:US
Practice Address - Phone:334-212-8690
Practice Address - Fax:334-212-8959
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7042G101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor