Provider Demographics
NPI:1164616173
Name:BROWDER, ALYSSA (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:BROWDER
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 OAK TREE LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-7192
Mailing Address - Country:US
Mailing Address - Phone:630-805-1635
Mailing Address - Fax:
Practice Address - Street 1:1220 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8542
Practice Address - Country:US
Practice Address - Phone:630-805-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL21253101YA0400X
IL180.006125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)