Provider Demographics
NPI:1881986123
Name:MCGEEHAN, JOHN BRENNAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BRENNAN
Last Name:MCGEEHAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CENTRAL PARK W
Mailing Address - Street 2:SUITE #1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4198
Mailing Address - Country:US
Mailing Address - Phone:917-620-6225
Mailing Address - Fax:
Practice Address - Street 1:115 CENTRAL PARK W
Practice Address - Street 2:SUITE #5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4198
Practice Address - Country:US
Practice Address - Phone:917-620-6225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073639-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker