MEDICARE: MRS. PLASHAN L. MCCUNE MS 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
1	101YP2500X	Professional Counselor		IL

General Provider Information

NPI Number	:	1376727081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PLASHAN L. MCCUNE MS LPC

Provider Business Mailing Address
First Line	:	10200 S LEAVITT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1912
Country	:	US
Telephone Number	:	773-239-7763
Fax Number	:	773-239-7794

Provider Business Practice Location Address
First Line	:	10200 S LEAVITT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1912
Country	:	US
Telephone Number	:	773-239-7763
Fax Number	:	773-239-7794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	12/18/2007

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