Provider Demographics
NPI:1932522489
Name:MCKEAGUE, ERIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:MCKEAGUE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 KENNETT PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-7306
Mailing Address - Country:US
Mailing Address - Phone:571-274-8427
Mailing Address - Fax:
Practice Address - Street 1:512 KENNETT PIKE
Practice Address - Street 2:SUITES 200 & 300
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7306
Practice Address - Country:US
Practice Address - Phone:571-274-8427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017472103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical