Provider Demographics
NPI:1689906018
Name:MCCONAGHAY, DEAN BARRY (MS)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:BARRY
Last Name:MCCONAGHAY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 BERKSHIRE BOULIVARD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1150
Mailing Address - Country:US
Mailing Address - Phone:610-373-7005
Mailing Address - Fax:610-373-8005
Practice Address - Street 1:1150 BERKSHIRE BOULIVARD
Practice Address - Street 2:SUITE 250
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-373-7005
Practice Address - Fax:610-373-8005
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006973L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical