Provider Demographics
NPI:1881074847
Name:MCGHEE, CARLA MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:MARIE
Other - Last Name:LA FARGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:3104 CARSKADDON AVE
Mailing Address - Street 2:APT 301
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1678
Mailing Address - Country:US
Mailing Address - Phone:630-649-0373
Mailing Address - Fax:
Practice Address - Street 1:3250 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-9297
Practice Address - Country:US
Practice Address - Phone:630-649-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional