MEDICARE: JULIE CROWE-MCCARTHY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178011804	IL

General Provider Information

NPI Number	:	1558831396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE CROWE-MCCARTHY

Provider Business Mailing Address
First Line	:	32 OAK AVE
Second Line	:
City	:	GRAYSLAKE
State	:	IL
Zip	:	60030-2333
Country	:	US
Telephone Number	:	608-239-2204
Fax Number	:

Provider Business Practice Location Address
First Line	:	34121 N US HIGHWAY 45
Second Line	:
City	:	THIRD LAKE
State	:	IL
Zip	:	60030-1768
Country	:	US
Telephone Number	:	608-239-2204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2018
Last Update Date	:	12/04/2018

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Directions to “ JULIE CROWE-MCCARTHY ” Practice Location

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