| Doctor Name: | DR. MICHAEL C MCDONOUGH |
| NPI Number: | 1689960221 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICENSED CLINICALPSY |
| License Number: | 2451 |
| Business Practice Address: | 112 Beech Street Suite 1a Gate City, VA - 24251 |
| Business Phone Number: | 2763868012 |
| Business Fax Number: | |
| Mailing Address: | 1447 Glenmar Ave, MT CARMEL |
| State: | TN |
| Postal Code: | 376453026 |
| Phone Number: | 2766905535 |
| Fax Number: | 2763862116 |
| NPI Enumeration Date: | 06/22/2011 |
| NPI Last Update Date: | 04/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |