Provider Demographics
NPI:1730896341
Name:MCGHEE, KIMBERLY SUSAN (LGPC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:SUSAN
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 PORTAL AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4839
Mailing Address - Country:US
Mailing Address - Phone:240-462-0861
Mailing Address - Fax:
Practice Address - Street 1:3721 PORTAL AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-4839
Practice Address - Country:US
Practice Address - Phone:240-462-0861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP6250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health