Provider Demographics
NPI:1235884867
Name:BEDOY, JENNIFER PAMELA (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAMELA
Last Name:BEDOY
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 1:7928 W OAKLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-1315
Mailing Address - Country:US
Mailing Address - Phone:773-983-2621
Mailing Address - Fax:
Practice Address - Street 1:1731 N MARCEY ST STE 510
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7955
Practice Address - Country:US
Practice Address - Phone:312-618-4867
Practice Address - Fax:312-280-1199
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178012819101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional