Provider Demographics
NPI:1942416474
Name:MCGARVEY, LOREN FRANK (LCSW)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:FRANK
Last Name:MCGARVEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 SANFORD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5247
Mailing Address - Country:US
Mailing Address - Phone:707-367-3626
Mailing Address - Fax:707-463-1649
Practice Address - Street 1:1480 SANFORD RANCH RD
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5247
Practice Address - Country:US
Practice Address - Phone:707-367-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW609451041C0700X
CA609451041C0700X
CAASW 296051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty