Provider Demographics
NPI:1740476910
Name:MCVEY, GAIA COSGROVE (LCPC)
Entity type:Individual
Prefix:MS
First Name:GAIA
Middle Name:COSGROVE
Last Name:MCVEY
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 1:1220 S PARK AVE
Mailing Address - Street 2:D
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-4128
Mailing Address - Country:US
Mailing Address - Phone:618-988-1757
Mailing Address - Fax:618-988-1700
Practice Address - Street 1:1220 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-4128
Practice Address - Country:US
Practice Address - Phone:618-988-1757
Practice Address - Fax:618-988-1700
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health