Provider Demographics
NPI:1750761490
Name:MCGUE, KRISTIN LH (PHD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LH
Last Name:MCGUE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 MILLBURN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1933
Mailing Address - Country:US
Mailing Address - Phone:973-378-5255
Mailing Address - Fax:973-378-5590
Practice Address - Street 1:90 MILLBURN AVE STE 102
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1933
Practice Address - Country:US
Practice Address - Phone:973-378-5255
Practice Address - Fax:973-378-5590
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05513103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical