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General NPI Number Information
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NPI Number | 1881074847
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Entity Type | Individual
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Provider Name | CARLA MARIE MCGHEE LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 3250 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-9297
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Country | US
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Telephone | 630-649-0373
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Fax |
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Provider Business Mailing Address
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Address Line | 3104 CARSKADDON AVE APT 301
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City | TOLEDO
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State | OH
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Zip | 43606-1678
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Country | US
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Telephone | 630-649-0373
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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 | 180.008395
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License Number State | IL
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