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General NPI Number Information
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NPI Number | 1871934786
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Entity Type | Individual
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Provider Name | SAMANTHA KAYLEE METOYER LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 33 W HIGGINS RD STE 2030
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City | SOUTH BARRINGTON
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State | IL
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Zip | 60010-9342
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Country | US
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Telephone | 847-844-0864
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Fax |
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Provider Business Mailing Address
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Address Line | 20 MARILYN CIR
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City | FAIRVIEW HEIGHTS
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State | IL
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Zip | 62208-2839
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Country | US
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Telephone | 224-204-7878
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178014543
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180015189
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License Number State | IL
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