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General NPI Number Information
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NPI Number | 1841115680
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Entity Type | Individual
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Provider Name | JACLYNN MCCARVILL
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 1440 RENAISSANCE DR STE 420
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City | PARK RIDGE
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State | IL
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Zip | 60068-1356
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Country | US
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Telephone | 773-280-7405
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 N KEYSTONE AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60651-3490
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Country | US
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Telephone | 929-519-2550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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