Provider Demographics
NPI:1104032978
Name:MCCONAGHY, MAUREEN J (MFT)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:J
Last Name:MCCONAGHY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4112
Mailing Address - Country:US
Mailing Address - Phone:714-587-8012
Mailing Address - Fax:714-538-9716
Practice Address - Street 1:4707 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4112
Practice Address - Country:US
Practice Address - Phone:714-587-8012
Practice Address - Fax:714-538-9716
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist