Provider Demographics
NPI:1205220605
Name:MCGEE, KELLY (LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MCGEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16402 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2321
Mailing Address - Country:US
Mailing Address - Phone:708-473-9400
Mailing Address - Fax:
Practice Address - Street 1:15010 S RAVINIA AVE STE 15
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5353
Practice Address - Country:US
Practice Address - Phone:708-364-0580
Practice Address - Fax:708-364-0480
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.003065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional