Basic Information
Provider Information
NPI: 1962171389
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: SHEQUITA
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 152 HIGHWAY 7 S
Address2:  
City: OXFORD
State: MS
PostalCode: 386555392
CountryCode: US
TelephoneNumber: 6622347521
FaxNumber: 6622363071
Practice Location
Address1: 152 HIGHWAY 7 S
Address2:  
City: OXFORD
State: MS
PostalCode: 386555392
CountryCode: US
TelephoneNumber: 6622347521
FaxNumber: 6622363071
Other Information
ProviderEnumerationDate: 09/09/2021
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
101YM0800XPH5563MSY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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