Provider Demographics
NPI:1811033608
Name:MCGREEVY, DEIRDRE KATHLEEN (MSW, LCSW, CEAP)
Entity Type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:KATHLEEN
Last Name:MCGREEVY
Suffix:
Gender:F
Credentials:MSW, LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 GILMARTIN ST
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-2145
Mailing Address - Country:US
Mailing Address - Phone:570-876-3930
Mailing Address - Fax:570-340-2150
Practice Address - Street 1:340 MONTAGE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1782
Practice Address - Country:US
Practice Address - Phone:570-346-3686
Practice Address - Fax:570-558-6838
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00536LTXMedicare ID - Type UnspecifiedMEDICARE
PAS61352Medicare UPIN