Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | GA- CPD0016 | GA |
N | 101YP1600X | Pastoral Counselor | 839 | GA |
N | 101YP2500X | Professional Counselor | LPC007918 | GA |
NPI | 1093978439 |
---|---|
Provider Name | Dr. Xavier Marquis Mccaskey |
First Address | Columbus, GA 31901-2383 |
Second Address | Columbus, GA 31901-2383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 26/07/2014 |