Provider Demographics
NPI:1316385701
Name:PAPANGELIS, STACY (LCPC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:PAPANGELIS
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 1:3600 N LAKE SHORE DR APT 618
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4609
Mailing Address - Country:US
Mailing Address - Phone:312-206-7466
Mailing Address - Fax:
Practice Address - Street 1:3600 N LAKE SHORE DR APT 618
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-4609
Practice Address - Country:US
Practice Address - Phone:312-206-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional