Provider Demographics
NPI:1235796442
Name:HALLONGREN, RUTH ARLENE (LCPC, PSYD)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ARLENE
Last Name:HALLONGREN
Suffix:
Gender:F
Credentials:LCPC, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 W MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1504
Mailing Address - Country:US
Mailing Address - Phone:954-805-0177
Mailing Address - Fax:
Practice Address - Street 1:4757 W MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1504
Practice Address - Country:US
Practice Address - Phone:954-805-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional