Michael C McDonough, LICENSED CLINICALPSY

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2451 Issued in VA

Practice address

112 Beech Street
Suite 1a
Gate City, VA 24251

Phone

(276) 386-8012

NPI assigned

Jun 22, 2011

Last updated

Apr 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Virginia Child Development Services

  • Clinical Psychologist
  • Gate City, VA
  • NPI 1134477060
  Medicare reassignment NPD Authorized official
• Southwest Virginia Child Development Services Corp

  • Clinical Psychologist
  • Gate City, VA
  • NPI 1982333167
  Medicare reassignment NPD

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1689960221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 GLENMAR AVE",
            "city": "MT CARMEL",
            "state": "TN",
            "postal_code": "376453026",
            "telephone_number": "276-690-5535",
            "fax_number": "276-386-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BEECH STREET",
            "address_2": "SUITE 1A",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "24251",
            "telephone_number": "276-386-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "LICENSED CLINICALPSY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "2451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa B Landore, DO
• Teresa Lynn Maness, LPTA
• Lindsay Nicole Martinez, PSY.D.
• Sadie Rebecca McAbee, M.S.
• Jason McCully, LPTA
• McKensie Graceann McGee, OTR/L
• Leslie Brooke McNew-Hall, FNP
• Shane Miller, RPH
• Christina Millinger, NP
• Jeffrey Montgomery, DDS

• Clinical Psychologist in Gate City, VA
• Providers in Gate City, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.