Provider Demographics
NPI:1144762808
Name:MCGINNIS, DENNIS P (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:P
Last Name:MCGINNIS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 GESELLE LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6952
Mailing Address - Country:US
Mailing Address - Phone:609-947-7067
Mailing Address - Fax:
Practice Address - Street 1:3360 GESELLE LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6952
Practice Address - Country:US
Practice Address - Phone:609-947-7067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-12
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN278661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical