Provider Demographics
NPI:1245495100
Name:MCALLISTER, LORI ANN (LCPC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:MCALLISTER
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 1:8 EAGLE CTR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1947
Mailing Address - Country:US
Mailing Address - Phone:618-792-6750
Mailing Address - Fax:
Practice Address - Street 1:8 EAGLE CTR
Practice Address - Street 2:SUITE #4
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1947
Practice Address - Country:US
Practice Address - Phone:618-792-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007777101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional