Provider Demographics
NPI:1730317017
Name:MCGINNIS, CAROL ZOANNE (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ZOANNE
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DALEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-2009
Mailing Address - Country:US
Mailing Address - Phone:410-628-7589
Mailing Address - Fax:
Practice Address - Street 1:13916 JARRETTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-2040
Practice Address - Country:US
Practice Address - Phone:410-666-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2972101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral