Provider Demographics
NPI:1649203621
Name:MCGINN, PATRICIA (LCPC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCGINN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5703 S KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1718
Mailing Address - Country:US
Mailing Address - Phone:773-363-8313
Mailing Address - Fax:773-288-7911
Practice Address - Street 1:5703 S KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1718
Practice Address - Country:US
Practice Address - Phone:773-363-8313
Practice Address - Fax:773-288-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01607996OtherBLUE CROSS BLUE SHIELD