Provider Demographics
NPI:1316053580
Name:FINEGAN, JAMES RICHARD (MSW LCSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:FINEGAN
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 W RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304
Mailing Address - Country:US
Mailing Address - Phone:623-979-1215
Mailing Address - Fax:623-979-1215
Practice Address - Street 1:6007 W RIVIERA DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304
Practice Address - Country:US
Practice Address - Phone:623-979-1215
Practice Address - Fax:623-979-1215
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 1706104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ759384Medicaid
AZ759384Medicare ID - Type Unspecified