Provider Demographics
NPI:1134317191
Name:WEBER, JOY ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ANN
Last Name:WEBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-2112
Mailing Address - Country:US
Mailing Address - Phone:815-933-6999
Mailing Address - Fax:
Practice Address - Street 1:700 REVERE ST
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4573
Practice Address - Country:US
Practice Address - Phone:815-936-6266
Practice Address - Fax:815-936-7606
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional