Provider Demographics
NPI:1770619207
Name:MCAVOY, PENNY J (LCSW)
Entity type:Individual
Prefix:MS
First Name:PENNY
Middle Name:J
Last Name:MCAVOY
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:2650 SUZANNE WAY
Mailing Address - Street 2:STE 120
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7619
Mailing Address - Country:US
Mailing Address - Phone:541-345-2800
Mailing Address - Fax:541-345-4419
Practice Address - Street 1:2650 SUZANNE WAY
Practice Address - Street 2:SUITE 120
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7619
Practice Address - Country:US
Practice Address - Phone:541-345-2800
Practice Address - Fax:541-345-4419
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORL912SR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical