Provider Demographics
NPI:1831502749
Name:MCNAMARA, JILLIAN (LPC, NCSP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LPC, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N WASHINGTON ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4559
Mailing Address - Country:US
Mailing Address - Phone:630-640-5013
Mailing Address - Fax:
Practice Address - Street 1:121 N WASHINGTON ST STE 150
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-267-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1908622103TS0200X
IL178003553101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool