Basic Information
Provider Information
NPI: 1811089923
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCPHAIL
FirstName: JOHN
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: CRC LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1031 E SAGINAW ST
Address2:  
City: LANSING
State: MI
PostalCode: 489065519
CountryCode: US
TelephoneNumber: 5174871003
FaxNumber: 5174871129
Practice Location
Address1: 5030 NORTHWIND DR
Address2: SUITE 108
City: EAST LANSING
State: MI
PostalCode: 488235034
CountryCode: US
TelephoneNumber: 5173364335
FaxNumber: 5173360101
Other Information
ProviderEnumerationDate: 09/28/2006
LastUpdateDate: 10/14/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X6401000258MIY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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