Provider Demographics
NPI:1275952640
Name:BOUNDS, PATRICE (LCPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, NCC
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-405-1742
Mailing Address - Fax:
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 425
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-405-1742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006929101YP2500X
IL180.010346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional