Provider Demographics
NPI:1073105540
Name:ERVING, LAFAY (LCPC)
Entity Type:Individual
Prefix:
First Name:LAFAY
Middle Name:
Last Name:ERVING
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 1:1146 S WAUKEGAN RD STE 378
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-6731
Mailing Address - Country:US
Mailing Address - Phone:224-788-0188
Mailing Address - Fax:
Practice Address - Street 1:1146 S WAUKEGAN RD STE 378
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6731
Practice Address - Country:US
Practice Address - Phone:224-788-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.015799101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor