Provider Demographics
NPI:1740467877
Name:MCGILL, HEIDI M (MS, LCPC, LPHA)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:M
Last Name:MCGILL
Suffix:
Gender:F
Credentials:MS, LCPC, LPHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 GALEN DR STE 108
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-7047
Mailing Address - Country:US
Mailing Address - Phone:217-531-2736
Mailing Address - Fax:217-531-2788
Practice Address - Street 1:2506 GALEN DR STE 108
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-7047
Practice Address - Country:US
Practice Address - Phone:217-531-2736
Practice Address - Fax:217-531-2788
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003503101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health