Provider Demographics
NPI:1316005184
Name:SINGH, JASLYN MADAN (LCPC,)
Entity Type:Individual
Prefix:MRS
First Name:JASLYN
Middle Name:MADAN
Last Name:SINGH
Suffix:
Gender:F
Credentials:LCPC,
Other - Prefix:
Other - First Name:JASLYN
Other - Middle Name:KAUR
Other - Last Name:MADAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 W BOUGHTON RD STE 200D
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4510
Mailing Address - Country:US
Mailing Address - Phone:630-882-5433
Mailing Address - Fax:
Practice Address - Street 1:440 W BOUGHTON RD STE 200D
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4510
Practice Address - Country:US
Practice Address - Phone:630-882-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232198OtherBCBS