Provider Demographics
NPI:1487669842
Name:METZGER-NEVILLE, PAULA ANN (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:METZGER-NEVILLE
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 GREEN BAY RD.
Mailing Address - Street 2:VA-BUILDING 131, ROOM 42
Mailing Address - City:N. CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064
Mailing Address - Country:US
Mailing Address - Phone:224-610-3528
Mailing Address - Fax:224-610-3778
Practice Address - Street 1:3001 GREEN BAY RD.
Practice Address - Street 2:VA-BUILDING 131, ROOM 42
Practice Address - City:N. CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:224-610-3528
Practice Address - Fax:224-610-3778
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002217101YP2500X
ILLCPC180-002217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional