Provider Demographics
NPI:1285643999
Name:MCSHERRY, MARYELLEN (LCPC)
Entity type:Individual
Prefix:
First Name:MARYELLEN
Middle Name:
Last Name:MCSHERRY
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:MARYELLEN
Other - Middle Name:
Other - Last Name:TAGLIA / CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5320 159TH ST STE 402-1
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4705
Mailing Address - Country:US
Mailing Address - Phone:708-307-6534
Mailing Address - Fax:
Practice Address - Street 1:5320 159TH ST STE 402-1
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4705
Practice Address - Country:US
Practice Address - Phone:708-307-6534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004220101YP2500X
IL180-004220104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional