Provider Demographics
NPI:1902103609
Name:MCGILLIVRAY, ABBY S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ABBY
Middle Name:S
Last Name:MCGILLIVRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-7327
Mailing Address - Country:US
Mailing Address - Phone:484-432-3667
Mailing Address - Fax:
Practice Address - Street 1:18 MYSTIC LN
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1942
Practice Address - Country:US
Practice Address - Phone:610-696-1543
Practice Address - Fax:610-696-1819
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0140531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067858Medicare PIN