Provider Demographics
NPI:1306390356
Name:WEINBLATT, STEPHANIE (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WEINBLATT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 REMINGTON RD STE N
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4844
Mailing Address - Country:US
Mailing Address - Phone:773-495-4954
Mailing Address - Fax:
Practice Address - Street 1:1375 REMINGTON RD STE N
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4844
Practice Address - Country:US
Practice Address - Phone:773-495-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1800096371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical