Provider Demographics
NPI:1326415936
Name:STEPHENS, PAULINA (LCPC)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:STEPHENS
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 1:2801 HIDDEN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3291
Mailing Address - Country:US
Mailing Address - Phone:847-338-6261
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD SUITE 210
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2079
Practice Address - Country:US
Practice Address - Phone:224-489-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional