Provider Demographics
NPI:1083196273
Name:EDWARDS, ALLISON COURTNEY (MA, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:COURTNEY
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8765 W. HIGGINS ROAD
Mailing Address - Street 2:STE. 450
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:773-693-0300
Mailing Address - Fax:
Practice Address - Street 1:1260 IROQUOIS AVE.
Practice Address - Street 2:STE. 102
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:773-391-3731
Practice Address - Fax:630-778-7542
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0155151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical