Provider Demographics
NPI:1578833430
Name:MCGUINNESS, SCOTT RYAN (LMHC, LPC, LADC, NCC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:RYAN
Last Name:MCGUINNESS
Suffix:
Gender:M
Credentials:LMHC, LPC, LADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SAREDON PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4070
Mailing Address - Country:US
Mailing Address - Phone:860-704-9641
Mailing Address - Fax:
Practice Address - Street 1:3 SAREDON PLACE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606
Practice Address - Country:US
Practice Address - Phone:860-704-9641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.002435101Y00000X
CT44.001120101YA0400X
NY18 006457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235918Medicaid