Provider Demographics
NPI:1871934786
Name:METOYER, SAMANTHA KAYLEE (LCPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KAYLEE
Last Name:METOYER
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 1:20 MARILYN CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-2839
Mailing Address - Country:US
Mailing Address - Phone:224-204-7878
Mailing Address - Fax:
Practice Address - Street 1:33 W HIGGINS RD STE 2030
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9342
Practice Address - Country:US
Practice Address - Phone:847-844-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178014543101YP2500X
IL180015189101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional