Provider Demographics
NPI:1558685966
Name:MCNICHOLS, MAUREEN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:MCNICHOLS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 DANADA CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2344
Mailing Address - Country:US
Mailing Address - Phone:630-248-8415
Mailing Address - Fax:
Practice Address - Street 1:1322 DANADA CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2344
Practice Address - Country:US
Practice Address - Phone:630-248-8415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional