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General NPI Number Information
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NPI Number | 1871899955
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Entity Type | Organization
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Legal Business Name | MGM FAMILY COUNSELING CENTER PLLC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 405 THE HILL
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City | PORTSMOUTH
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State | NH
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Zip | 03801
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Country | US
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Telephone | 978-697-9213
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Fax | 603-617-3410
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Provider Business Mailing Address
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Address Line | 361 OCEAN RD
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City | PORTSMOUTH
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State | NH
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Zip | 03801-6020
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Country | US
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Telephone | 978-697-9213
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Fax | 603-617-3410
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL GEORGE MCCAY
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Credential | LMFT
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Telephone | 978-697-9213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 119
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License Number State | NH
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