Healthcare Provider Details

I. General information

NPI: 1164871836
Provider Name (Legal Business Name): MEGAN GARCIA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 W SHAMROCK LN UNIT C
MCHENRY IL
60050-8700
US

IV. Provider business mailing address

4209 W SHAMROCK LN UNIT C
MCHENRY IL
60050-8700
US

V. Phone/Fax

Practice location:
  • Phone: 815-344-9443
  • Fax: 815-344-9445
Mailing address:
  • Phone: 815-344-9443
  • Fax: 815-344-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178017168
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: