Provider Demographics
NPI:1497932339
Name:MCEVOY, MEGHAN MCGILLOWAY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:MCGILLOWAY
Last Name:MCEVOY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 FURNACE BROOK PKWY
Mailing Address - Street 2:SUITE 31
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4721
Mailing Address - Country:US
Mailing Address - Phone:617-479-1043
Mailing Address - Fax:617-479-4555
Practice Address - Street 1:1261 FURNACE BROOK PKWY
Practice Address - Street 2:SUITE 31
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4721
Practice Address - Country:US
Practice Address - Phone:617-479-1043
Practice Address - Fax:617-479-4555
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical