Provider Demographics
NPI:1558899104
Name:MCGINNESS, MARY CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:MCGINNESS
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 1:5546 SE W HWY
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:MO
Mailing Address - Zip Code:64465-9360
Mailing Address - Country:US
Mailing Address - Phone:816-632-8551
Mailing Address - Fax:
Practice Address - Street 1:302 S PLATTE CLAY WAY
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-8500
Practice Address - Country:US
Practice Address - Phone:816-482-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160359081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty