Provider Demographics
NPI:1316242134
Name:MCCONAGHIE, ANDREW (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MCCONAGHIE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 N POINT PKWY
Mailing Address - Street 2:SUITE 75
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1142
Mailing Address - Country:US
Mailing Address - Phone:770-645-8933
Mailing Address - Fax:770-645-0364
Practice Address - Street 1:5755 N POINT PKWY
Practice Address - Street 2:SUITE 75
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1142
Practice Address - Country:US
Practice Address - Phone:770-645-8933
Practice Address - Fax:770-645-0364
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA18571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical