Provider Demographics
NPI:1285179820
Name:TESSERS, BRANDON (LCPC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:TESSERS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 PARTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4428
Mailing Address - Country:US
Mailing Address - Phone:801-403-1790
Mailing Address - Fax:
Practice Address - Street 1:2421 PARTRIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4428
Practice Address - Country:US
Practice Address - Phone:801-403-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.013285101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health