Provider Demographics
NPI:1699125724
Name:MCGUIRE, BLAIR DOYLE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:DOYLE
Last Name:MCGUIRE
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 1:2142 W WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8156
Mailing Address - Country:US
Mailing Address - Phone:847-471-0949
Mailing Address - Fax:
Practice Address - Street 1:2142 W WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-8156
Practice Address - Country:US
Practice Address - Phone:847-471-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional