Provider Demographics
NPI:1740571058
Name:MCGINN, ANDREA DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DENISE
Last Name:MCGINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8813
Mailing Address - Country:US
Mailing Address - Phone:865-212-9915
Mailing Address - Fax:
Practice Address - Street 1:1918 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-8813
Practice Address - Country:US
Practice Address - Phone:865-212-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical