Provider Demographics
NPI:1205566767
Name:MCGARRY, BECKY
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:MCGARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-2936
Mailing Address - Country:US
Mailing Address - Phone:815-985-8603
Mailing Address - Fax:
Practice Address - Street 1:800 S MCHENRY AVE STE F
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7487
Practice Address - Country:US
Practice Address - Phone:815-985-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000884106H00000X
IL178.018045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist