Mackenzie R Pherigo, LCSW, CADC
Social Worker, Clinical in Granite City, IL. Individual provider (NPI-1).
NPI number1801002142
StatusActive
Last updated in NPPESNov 6, 2026
Details
- NPI
- 1801002142
- Entity type
- Individual (NPI-1)
- Name
- Mackenzie R Pherigo
- Credential
- LCSW, CADC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 15, 2007
- Certification date
- Nov 6, 2026
- Last updated
- Nov 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149.013008 | IL | Yes |
| 104100000X | Social Worker | 150.009882 | IL |
Practice location
50 Northgate Industrial DrGranite City, IL 62040-6805
Phone 618-877-4420
Mailing address
1003 Martin Luther King DrBloomington, IL 61701-1429
Phone 888-924-3786
Other practice locations
2148 Vadalabene Dr
Maryville, IL 62062-5632
Maryville, IL 62062-5632
Phone 618-288-3100 · Fax 618-288-3371
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