Provider Demographics
NPI:1558559427
Name:MCGINTY, SHANNON KATHLEEN (LPCC-S)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:KATHLEEN
Last Name:MCGINTY
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:MRS
Other - First Name:SHANNON
Other - Middle Name:KATHLEEN
Other - Last Name:BOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 E CAMPUS VIEW BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4682
Mailing Address - Country:US
Mailing Address - Phone:614-594-8759
Mailing Address - Fax:614-748-0625
Practice Address - Street 1:100 E CAMPUS VIEW BLVD STE 250
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4682
Practice Address - Country:US
Practice Address - Phone:614-594-8759
Practice Address - Fax:614-748-0625
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500554101YP2500X
OHE0500554SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid