Provider Demographics
NPI:1841471091
Name:MCCARTY, TRINA KAY (LCPC)
Entity type:Individual
Prefix:MS
First Name:TRINA
Middle Name:KAY
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:TRINA
Other - Middle Name:KAY
Other - Last Name:MCCARTY-STEFL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:711 E WALNUT ST
Mailing Address - Street 2:2E
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-8646
Mailing Address - Country:US
Mailing Address - Phone:309-310-5545
Mailing Address - Fax:
Practice Address - Street 1:200 W MONROE ST
Practice Address - Street 2:SUITE 306
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3997
Practice Address - Country:US
Practice Address - Phone:309-310-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health