Provider Demographics
NPI:1093369118
Name:MCGUIRE, MARY-CHRISTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY-CHRISTINE
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY-CHRISTINE
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-2539
Practice Address - Country:US
Practice Address - Phone:253-982-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2022-09-30
Deactivation Date:2021-01-03
Deactivation Code:
Reactivation Date:2021-08-03
Provider Licenses
StateLicense IDTaxonomies
NCC0142441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical