Provider Demographics
NPI:1619391455
Name:AMELIA MCGINNIS, LCSW, LLC
Entity Type:Organization
Organization Name:AMELIA MCGINNIS, LCSW, LLC
Other - Org Name:MCGINNIS COUNSELING & CONSULTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER/SOLE MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MCGINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:814-883-1311
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:PA
Mailing Address - Zip Code:16851-0465
Mailing Address - Country:US
Mailing Address - Phone:814-883-1311
Mailing Address - Fax:
Practice Address - Street 1:921 PIKE STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:LEMONT
Practice Address - State:PA
Practice Address - Zip Code:16851
Practice Address - Country:US
Practice Address - Phone:814-883-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW017601251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health