Provider Demographics
NPI:1184963597
Name:MCKEE-NASTASE, JULIA PATRICIA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:PATRICIA
Last Name:MCKEE-NASTASE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MISS
Other - First Name:JULIA
Other - Middle Name:PATRICIA
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:115 N MARION ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1503
Mailing Address - Country:US
Mailing Address - Phone:312-206-4625
Mailing Address - Fax:
Practice Address - Street 1:115 N MARION ST
Practice Address - Street 2:SUITE 6
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1503
Practice Address - Country:US
Practice Address - Phone:312-206-4625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional