Provider Demographics
NPI:1124047006
Name:MCGUINNESS, D PATRICK (MA)
Entity type:Individual
Prefix:
First Name:D
Middle Name:PATRICK
Last Name:MCGUINNESS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 E 1400 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-7714
Mailing Address - Country:US
Mailing Address - Phone:801-854-7942
Mailing Address - Fax:801-854-7943
Practice Address - Street 1:570 E 1400 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-7714
Practice Address - Country:US
Practice Address - Phone:801-854-7942
Practice Address - Fax:801-854-7943
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423027Medicaid