Provider Demographics
NPI:1720251861
Name:MCGUIRE, SUSAN M (MED, LPC, NCC, MAC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MED, LPC, NCC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 COUNTRY CLUB RD
Mailing Address - Street 2:SUITE P
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3370
Mailing Address - Country:US
Mailing Address - Phone:636-940-9511
Mailing Address - Fax:636-724-2951
Practice Address - Street 1:1000 COUNTRY CLUB RD
Practice Address - Street 2:SUITE P
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3370
Practice Address - Country:US
Practice Address - Phone:636-940-9511
Practice Address - Fax:636-724-2951
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO001978101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional