Provider Demographics
NPI:1487823977
Name:MCCARTHY, AMANDA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
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:NORTHERN ILLINOIS UNIVERSITY
Mailing Address - Street 2:DEPARTMENT OF COMMUNICATIVE DISORDERS 323J WIRTZ HALL
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115
Mailing Address - Country:US
Mailing Address - Phone:815-753-1893
Mailing Address - Fax:
Practice Address - Street 1:ALLIED HEALTH AND COMMUNICATIVE DISORDERS
Practice Address - Street 2:323J WIRTZ HALL NORTHERN ILLINOIS UNIVERSITY
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115
Practice Address - Country:US
Practice Address - Phone:815-753-1893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional