Provider Demographics
NPI:1891327870
Name:KERR, MEAGAN COLLEEN MARY (LPC NCC CADC PCGC)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:COLLEEN MARY
Last Name:KERR
Suffix:
Gender:F
Credentials:LPC NCC CADC PCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15W437 GRAND PL
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1378
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5201 WASHINGTON ST STE 2
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5068
Practice Address - Country:US
Practice Address - Phone:630-802-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1708011271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health