Individual
MICHAEL JOSEPH DEEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 951-2807
(304) 414-4917
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 951-2807
(304) 414-4917
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DPOO454979
WV
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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