Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | LP-0449 | KS |
Y | 103T00000X | Psychologist | LP-0449 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | LP-0449 | KS |
NPI | 1114941317 |
---|---|
Provider Name | Mr. James P Mchugh |
First Address | Lenexa, KS 66285-4814 |
Second Address | Overland Park, KS 66207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 01/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004642C | MEDICARE ID (01) | KS |
481192008 | TAX ID (01) |