Provider Demographics
NPI:1598143141
Name:MCGUILL, RORY (LCSW)
Entity Type:Individual
Prefix:
First Name:RORY
Middle Name:
Last Name:MCGUILL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 INDIAN SCHOOL RD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4504
Mailing Address - Country:US
Mailing Address - Phone:505-266-0441
Mailing Address - Fax:505-266-0504
Practice Address - Street 1:7301 INDIAN SCHOOL RD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4504
Practice Address - Country:US
Practice Address - Phone:505-266-0441
Practice Address - Fax:505-266-0504
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-084461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical