Provider Demographics
NPI:1144779547
Name:MARQUART, STEPHANIE CHRISTINE FUCHS (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CHRISTINE FUCHS
Last Name:MARQUART
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:488 N MAIN ST STE 2N
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5126
Mailing Address - Country:US
Mailing Address - Phone:865-378-5202
Mailing Address - Fax:
Practice Address - Street 1:488 N MAIN ST STE 2N
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5126
Practice Address - Country:US
Practice Address - Phone:865-378-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional