Provider Demographics
NPI:1275240111
Name:LOSER, STEVEN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LOSER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 W HOLLOW CREEK DR APT 910
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-2489
Mailing Address - Country:US
Mailing Address - Phone:309-645-1835
Mailing Address - Fax:
Practice Address - Street 1:1820 N STERLING AVE
Practice Address - Street 2:
Practice Address - City:WEST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-6433
Practice Address - Country:US
Practice Address - Phone:309-212-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178016683101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor