Provider Demographics
NPI:1083115661
Name:TEIXEIRA, CELSO EDWARD (LPC)
Entity Type:Individual
Prefix:MR
First Name:CELSO
Middle Name:EDWARD
Last Name:TEIXEIRA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1824
Mailing Address - Country:US
Mailing Address - Phone:224-707-0720
Mailing Address - Fax:
Practice Address - Street 1:342 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-1824
Practice Address - Country:US
Practice Address - Phone:224-707-0720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173F00000X
IL178.013680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No173F00000XOther Service ProvidersSleep Specialist, PhD