Provider Demographics
NPI:1508330374
Name:MCGINN, JESSICA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:MCGINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 HALF HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5859
Mailing Address - Country:US
Mailing Address - Phone:631-370-1800
Mailing Address - Fax:631-370-1714
Practice Address - Street 1:197 HALF HOLLOW RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5859
Practice Address - Country:US
Practice Address - Phone:631-370-1800
Practice Address - Fax:631-370-1714
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0966721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1386817906Medicaid