Provider Demographics
NPI:1053069849
Name:MCGUIRE, BENNIE C III
Entity Type:Individual
Prefix:MR
First Name:BENNIE
Middle Name:C
Last Name:MCGUIRE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 MARSOL RD APT 325
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3509
Mailing Address - Country:US
Mailing Address - Phone:216-526-1474
Mailing Address - Fax:
Practice Address - Street 1:6505 MARSOL RD APT 325
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-3509
Practice Address - Country:US
Practice Address - Phone:216-526-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty