Individual provider Active NPI

Jeanna McGill, MA

  • Psychologist
  • Charleston, WV
National Provider Identifier
1427570076
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1161 Issued in WV
Practice address
4602 Maccorkle Ave SE
Charleston, WV 25304-1848
Phone
(304) 205-7535
NPI assigned
Jul 14, 2017
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1161 WV Primary

Addresses

Primary practice location

4602 Maccorkle Ave SE
Charleston, WV 25304-1848

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829000902 WV Practitioner - Clinical Psychologist 3072886902 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Cabin Creek Health Center, Inc. CurrentSince May 17, 2023 Accepting new patients
Cabin Creek Health Center, Inc. CurrentSince May 17, 2023 Accepting new patients
Cabin Creek Health Center, Inc. Past Accepting new patients

Locations

1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591

4602 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 205-7535

6135 Sissonville Dr
Charleston, WV 25312
Phone (304) 343-8030

104 Alex Ln
Charleston, WV 25304
Phone 30473420401319

107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1427570076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041848",
            "telephone_number": "304-205-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "JEANNA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "1161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.