Provider Demographics
NPI:1568036465
Name:MCGUFFEY, LAWANA V (ACLC, SWLC, MSW)
Entity Type:Individual
Prefix:
First Name:LAWANA
Middle Name:V
Last Name:MCGUFFEY
Suffix:
Gender:F
Credentials:ACLC, SWLC, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:MT
Mailing Address - Zip Code:59872-0298
Mailing Address - Country:US
Mailing Address - Phone:406-396-8032
Mailing Address - Fax:
Practice Address - Street 1:247 HOSANNA RANCH LN
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:MT
Practice Address - Zip Code:59872-3070
Practice Address - Country:US
Practice Address - Phone:406-396-8032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT434921041C0700X
MT43493101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty