Provider Demographics
NPI:1871845701
Name:MCGRATH, DEBORAH ANN (MS,LCPC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:MS,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 N PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-2310
Mailing Address - Country:US
Mailing Address - Phone:630-879-2859
Mailing Address - Fax:
Practice Address - Street 1:130 N PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2310
Practice Address - Country:US
Practice Address - Phone:630-879-2859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180,001276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional