1861290801 NPI number — MR. CHRISTOPHER DALE MCGUIRE LPCA

Table of content: MR. CHRISTOPHER DALE MCGUIRE LPCA (NPI 1861290801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861290801 NPI number — MR. CHRISTOPHER DALE MCGUIRE LPCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGUIRE
Provider First Name:
CHRISTOPHER
Provider Middle Name:
DALE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPCA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861290801
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 RICHMOND STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT VERNON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-256-3332
Provider Business Mailing Address Fax Number:
606-256-3334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 RICHMOND STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT VERNON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-256-3332
Provider Business Practice Location Address Fax Number:
606-256-3334
Provider Enumeration Date:
03/05/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  297563 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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