Provider Demographics
NPI:1871737791
Name:MCGARGILL, MICHAEL J (LMHC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:MCGARGILL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 ANNE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2007
Mailing Address - Country:US
Mailing Address - Phone:712-370-6846
Mailing Address - Fax:866-675-5954
Practice Address - Street 1:1101 E SUMMIT ST STE 2
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566-2049
Practice Address - Country:US
Practice Address - Phone:712-370-6846
Practice Address - Fax:866-675-5954
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health