Healthcare Provider Details

I. General information

NPI: 1124047006
Provider Name (Legal Business Name): D PATRICK MCGUINNESS MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 E 1400 S
OREM UT
84097-7714
US

IV. Provider business mailing address

570 E 1400 S
OREM UT
84097-7714
US

V. Phone/Fax

Practice location:
  • Phone: 801-854-7942
  • Fax: 801-854-7943
Mailing address:
  • Phone: 801-854-7942
  • Fax: 801-854-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number337
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: