Provider Demographics
NPI:1760666358
Name:MCMAHON, MEREDITH ELAINE (PSYD, CADC, LCPC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ELAINE
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PSYD, CADC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 MOON LAKE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5029
Mailing Address - Country:US
Mailing Address - Phone:847-755-8090
Mailing Address - Fax:847-843-7393
Practice Address - Street 1:1786 MOON LAKE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5029
Practice Address - Country:US
Practice Address - Phone:847-755-8090
Practice Address - Fax:847-843-7393
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-007472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health