Provider Demographics
NPI:1225292519
Name:RON MCGUIRE FAMILY THERAPY CENTER
Entity Type:Organization
Organization Name:RON MCGUIRE FAMILY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW ACSW LICSW LMFT
Authorized Official - Phone:507-454-4890
Mailing Address - Street 1:51 E 4TH ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-3507
Mailing Address - Country:US
Mailing Address - Phone:507-454-4890
Mailing Address - Fax:507-454-4890
Practice Address - Street 1:51 E 4TH ST
Practice Address - Street 2:SUITE 307
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3507
Practice Address - Country:US
Practice Address - Phone:507-454-4890
Practice Address - Fax:507-454-4890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1905251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management