Provider Demographics
NPI:1073986626
Name:REUTHER, LENEL COLLEEN (LPC)
Entity Type:Individual
Prefix:
First Name:LENEL
Middle Name:COLLEEN
Last Name:REUTHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LENEL
Other - Middle Name:
Other - Last Name:REUTHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1320 S WHITE OAK DR
Mailing Address - Street 2:APARTMENT 636
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-8376
Mailing Address - Country:US
Mailing Address - Phone:708-899-6355
Mailing Address - Fax:
Practice Address - Street 1:16595 W EASTON AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2744
Practice Address - Country:US
Practice Address - Phone:708-899-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional