Provider Demographics
NPI:1780081570
Name:MCGUIRE THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:MCGUIRE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RASHEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-731-1222
Mailing Address - Street 1:9320 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3100
Mailing Address - Country:US
Mailing Address - Phone:301-731-1222
Mailing Address - Fax:301-358-6478
Practice Address - Street 1:9320 ANNAPOLIS RD
Practice Address - Street 2:SUITE 340
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3100
Practice Address - Country:US
Practice Address - Phone:301-731-1222
Practice Address - Fax:301-358-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2438251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417726600Medicaid