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NPI Code Detail

MEDICARE: MICHAEL MCGOLDRICK

MEDICARE: MICHAEL MCGOLDRICK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1578496790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MCGOLDRICK
Provider Business Mailing Address
First Line : 104 GEORGE BISHOP PKWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-7335
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 104 GEORGE BISHOP PKWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-7335
Country : US
Telephone Number : 866-850-3858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2026
Last Update Date : 06/06/2026

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