Provider Demographics
NPI:1932648375
Name:MCCARTY, VICKIE (LPC)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:MCCARTY
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 1:822 W VERMILION ST
Mailing Address - Street 2:
Mailing Address - City:CATLIN
Mailing Address - State:IL
Mailing Address - Zip Code:61817-9644
Mailing Address - Country:US
Mailing Address - Phone:217-621-7093
Mailing Address - Fax:
Practice Address - Street 1:822 W VERMILION ST
Practice Address - Street 2:
Practice Address - City:CATLIN
Practice Address - State:IL
Practice Address - Zip Code:61817-9644
Practice Address - Country:US
Practice Address - Phone:217-621-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17849101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral