Provider Demographics
NPI:1013036953
Name:CERNEY, ANN LOUISE (MS LCPC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:LOUISE
Last Name:CERNEY
Suffix:
Gender:F
Credentials:MS LCPC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:4300 COMMERCE CT
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3698
Mailing Address - Country:US
Mailing Address - Phone:630-291-4393
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMERCE CT
Practice Address - Street 2:SUITE 310
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3698
Practice Address - Country:US
Practice Address - Phone:630-291-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health