Provider Demographics
NPI:1922359876
Name:MCGUIRE CHRISTIAN COUNSELING INC
Entity Type:Organization
Organization Name:MCGUIRE CHRISTIAN COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYBARCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:417-753-5211
Mailing Address - Street 1:205 PARK CENTRAL E
Mailing Address - Street 2:SUITE 316
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-1317
Mailing Address - Country:US
Mailing Address - Phone:417-866-7773
Mailing Address - Fax:
Practice Address - Street 1:776 S LLOYD DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-9111
Practice Address - Country:US
Practice Address - Phone:417-753-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012033768101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1912141789Medicaid