MEDICARE: MRS. STEPHANIE ANNE CAREY M.A., LCPC

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	180.007230	IL
2	101YM0800X	Mental Health Counselor	180.007230	IL

General Provider Information

NPI Number	:	1588790620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE ANNE CAREY M.A., LCPC

Provider Business Mailing Address
First Line	:	5149 ROWENA DR
Second Line	:
City	:	ROSCOE
State	:	IL
Zip	:	61073-9407
Country	:	US
Telephone Number	:	815-703-7542
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 E STATE ST STE 302
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2399
Country	:	US
Telephone Number	:	815-703-7542
Fax Number	:	815-977-5929

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

Provider Enumeration Date	:	02/25/2007
Last Update Date	:	04/10/2026

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