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General NPI Number Information
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NPI Number | 1235778283
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Entity Type | Individual
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Provider Name | CAROLYN HOVEY MCGINNIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/22/2019
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 480 PIERCE ST STE 300
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City | KINGSTON
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State | PA
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Zip | 18704-5512
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Country | US
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Telephone | 570-239-0907
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Fax |
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Provider Business Mailing Address
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Address Line | 11 JOHNSON ST
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City | MOUNTAIN TOP
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State | PA
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Zip | 18707-1001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CW020397
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License Number State | PA
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