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General NPI Number Information
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NPI Number | 1114229523
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Entity Type | Organization
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Legal Business Name | MCCONAGHIE FAMILY COUNSELING
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 5755 N POINT PKWY SUITE 75
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City | ALPHARETTA
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State | GA
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Zip | 30022-1142
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Country | US
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Telephone | 770-645-8933
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Fax | 770-645-0364
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Provider Business Mailing Address
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Address Line | 5755 N POINT PKWY SUITE 75
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City | ALPHARETTA
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State | GA
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Zip | 30022-1142
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Country | US
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Telephone | 770-645-8933
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Fax | 770-645-0364
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ANDREW MCCONAGHIE
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Credential | LCSW
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Telephone | 770-645-8933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1857
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License Number State | GA
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