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General NPI Number Information
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NPI Number | 1710619994
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Entity Type | Organization
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Legal Business Name | SHANNON MCGRATH, LCSW, LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 541 WILLAMETTE ST STE 407A
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City | EUGENE
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State | OR
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Zip | 97401-2696
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Country | US
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Telephone | 907-230-6619
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Fax | 541-359-4049
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Provider Business Mailing Address
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Address Line | 1303 BETTY LN
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City | EUGENE
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State | OR
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Zip | 97404-2806
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Country | US
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Telephone | 907-230-6619
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Fax |
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Authorized Official
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Title or Position | OWNER AND PROVIDER
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Name | SHANNON RACHEL MCGRATH
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Credential | LCSW
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Telephone | 907-230-6619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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