Basic Information
| Provider Information | |||||||||
| NPI: | 1265820286 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGARITY | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | GRACE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 W MONROE ST STE 1200 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606032420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127339730 | ||||||||
| FaxNumber: | 7738668014 | ||||||||
| Practice Location | |||||||||
| Address1: | 1142 E 9 MILE RD | ||||||||
| Address2: | |||||||||
| City: | HAZEL PARK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480301901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488174742 | ||||||||
| FaxNumber: | 2485188719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2014 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.