Provider Demographics
NPI:1518188242
Name:MCGINN, PATRICK MICHAEL (MS, LLP)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:MCGINN
Suffix:
Gender:M
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14557 INVERNESS TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-9313
Mailing Address - Country:US
Mailing Address - Phone:231-597-8182
Mailing Address - Fax:
Practice Address - Street 1:524 MACKINAW AVE
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1145
Practice Address - Country:US
Practice Address - Phone:231-597-8024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical