Provider Demographics
NPI:1821434275
Name:MCCAFFERY, MAUREEN (MSED, CAGS)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MCCAFFERY
Suffix:
Gender:F
Credentials:MSED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 OLD TAMAH RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9000
Mailing Address - Country:US
Mailing Address - Phone:803-476-4834
Mailing Address - Fax:
Practice Address - Street 1:1528 OLD TAMAH RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9000
Practice Address - Country:US
Practice Address - Phone:803-476-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201036103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist