Provider Demographics
NPI:1164593729
Name:MCCONAGHY, JOHN S (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:S
Last Name:MCCONAGHY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7167 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130
Mailing Address - Country:US
Mailing Address - Phone:314-727-1939
Mailing Address - Fax:
Practice Address - Street 1:4601 MORGANFORD RD
Practice Address - Street 2:ST. LOUIS ACADEMY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1409
Practice Address - Country:US
Practice Address - Phone:314-481-5100
Practice Address - Fax:314-259-1147
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001004874101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health