Healthcare Provider Details

I. General information

NPI: 1689191595
Provider Name (Legal Business Name): MCGREW BEHAVIORAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 08/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 THERESA AVE
AMERICAN CANYON CA
94503-9654
US

IV. Provider business mailing address

229 NEWBURY WAY
AMERICAN CANYON CA
94503-4228
US

V. Phone/Fax

Practice location:
  • Phone: 707-246-7920
  • Fax: 707-649-0393
Mailing address:
  • Phone: 707-246-7920
  • Fax: 707-648-0393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH MCGREW
Title or Position: EXECUTIVE DIRECTOR
Credential: BCBA-D; LMTF; LPCC
Phone: 707-246-7920