Provider Demographics
NPI:1144493057
Name:HOUGH, PEGGY (LCPC)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:HOUGH
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 1:2530 CRAWFORD AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4954
Mailing Address - Country:US
Mailing Address - Phone:847-425-1778
Mailing Address - Fax:847-563-8162
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-425-1778
Practice Address - Fax:847-563-8162
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional