Provider Demographics
NPI:1902227663
Name:MCGUIRE, COURTNEY ALLISON (MASTERS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALLISON
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:ST. ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478
Mailing Address - Country:US
Mailing Address - Phone:802-922-5629
Mailing Address - Fax:401-722-5280
Practice Address - Street 1:186 LAKE ST.
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478
Practice Address - Country:US
Practice Address - Phone:802-922-5629
Practice Address - Fax:401-722-5280
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-26
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid