Provider Demographics
NPI:1356072888
Name:MAGUIRE, ALLYSON LACEY (LPC--A, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:LACEY
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:LPC--A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GADSDEN STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401
Mailing Address - Country:US
Mailing Address - Phone:704-604-4579
Mailing Address - Fax:
Practice Address - Street 1:65 GADSDEN STREET
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401
Practice Address - Country:US
Practice Address - Phone:704-604-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional