Provider Demographics
NPI:1497300149
Name:MCGUYER, JODY (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:MCGUYER
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:MS
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:MCGUYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC, CADC
Mailing Address - Street 1:315 W. COURT ST.
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3640
Mailing Address - Country:US
Mailing Address - Phone:708-977-7492
Mailing Address - Fax:
Practice Address - Street 1:315 W. COURT ST.
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3640
Practice Address - Country:US
Practice Address - Phone:708-977-7492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty