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NPI Code Detail

MEDICARE: KATIE MCEVOY LPC

MEDICARE:   KATIE  MCEVOY  LPC
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
1101YP2500XProfessional Counselor178015296IL

General Provider Information

NPI Number : 1235713744
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE MCEVOY LPC
Provider Business Mailing Address
First Line : 614 N 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-5313
Country : US
Telephone Number : 217-528-3694
Fax Number :
Provider Business Practice Location Address
First Line : 614 N 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-5313
Country : US
Telephone Number : 217-528-3694
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

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Directions to “ KATIE MCEVOY LPC” Practice Location

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