Provider Demographics
NPI:1326529421
Name:CHAVEZ, ALLISON ANN (LMFT, CADC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ANN
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:LMFT, CADC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:ANN
Other - Last Name:CULPEPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6912 YOUNG CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517
Mailing Address - Country:US
Mailing Address - Phone:630-440-3696
Mailing Address - Fax:
Practice Address - Street 1:6912 YOUNG CT
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517
Practice Address - Country:US
Practice Address - Phone:630-440-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL25880101YA0400X
IL166000958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)