Individual
MEAGHAN LAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LCPC
Contact information
Practice address
4010 S CALUMET AVE APT 3S, CHICAGO, IL 60653-2202
(872) 228-7225
Mailing address
4010 S CALUMET AVE APT 3S, CHICAGO, IL 60653-2202
(872) 228-7225
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180015814
IL
101Y00000X
Counselor
2018033173
MO
101YP2500X
Professional Counselor
180015814
IL
101YP2500X
Professional Counselor
2018033173
MO
Other
Enumeration date
04/26/2025
Last updated
04/26/2025
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