Provider Demographics
NPI:1073925020
Name:MCKILLOP, CHRIS (LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:MCKILLOP
Suffix:
Gender:M
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3251
Mailing Address - Country:US
Mailing Address - Phone:704-238-8195
Mailing Address - Fax:
Practice Address - Street 1:410 JOHN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3251
Practice Address - Country:US
Practice Address - Phone:704-238-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10581101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor