Provider Demographics
NPI:1114229523
Name:MCCONAGHIE FAMILY COUNSELING
Entity Type:Organization
Organization Name:MCCONAGHIE FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONAGHIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-645-8933
Mailing Address - Street 1:5755 N POINT PKWY
Mailing Address - Street 2:SUITE 75
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1142
Mailing Address - Country:US
Mailing Address - Phone:770-645-8933
Mailing Address - Fax:770-645-0364
Practice Address - Street 1:5755 N POINT PKWY
Practice Address - Street 2:SUITE 75
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1142
Practice Address - Country:US
Practice Address - Phone:770-645-8933
Practice Address - Fax:770-645-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA18571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty