Individual
MR. ALLAN MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW-LCSW-QMHP
Contact information
Practice address
11 4TH ST E, LEMMON, SD 57638-1524
(605) 374-3862
(605) 374-3864
Mailing address
PO BOX 447, LEMMON, SD 57638-0447
(605) 374-3862
(605) 374-3864
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1082
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4996764
BCBS PROVIDER #
SD
Enumeration date
12/22/2006
Last updated
07/08/2007
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