Provider Demographics
NPI:1124596820
Name:MCGINNIS, JOSEPH ROLLAND (BBA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ROLLAND
Last Name:MCGINNIS
Suffix:
Gender:M
Credentials:BBA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:765 E HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-4707
Mailing Address - Country:US
Mailing Address - Phone:810-233-5340
Mailing Address - Fax:810-233-3565
Practice Address - Street 1:765 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4707
Practice Address - Country:US
Practice Address - Phone:810-233-5340
Practice Address - Fax:810-233-3565
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)