Provider Demographics
NPI:1568571156
Name:MCGOEY BRENNAN, CHEVONNE MARIE (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CHEVONNE
Middle Name:MARIE
Last Name:MCGOEY BRENNAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3703
Mailing Address - Country:US
Mailing Address - Phone:978-604-4444
Mailing Address - Fax:978-664-0944
Practice Address - Street 1:21 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3703
Practice Address - Country:US
Practice Address - Phone:978-604-4444
Practice Address - Fax:978-664-0944
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10267441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical