Provider Demographics
NPI:1205275310
Name:MAGINNIS, MEREDITH MEGAN DILLON (BSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MEGAN DILLON
Last Name:MAGINNIS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SILVER LAKE RD E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-2908
Mailing Address - Country:US
Mailing Address - Phone:662-380-2424
Mailing Address - Fax:
Practice Address - Street 1:1421 BLUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4809
Practice Address - Country:US
Practice Address - Phone:803-733-5855
Practice Address - Fax:803-733-5892
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)