Provider Demographics
NPI:1346539731
Name:LAMBRECHT, JEANNE LOUISE (PHD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:LOUISE
Last Name:LAMBRECHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26152 E 1300 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:61737-9526
Mailing Address - Country:US
Mailing Address - Phone:309-533-2147
Mailing Address - Fax:
Practice Address - Street 1:26152 E 1300 NORTH RD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:IL
Practice Address - Zip Code:61737-9526
Practice Address - Country:US
Practice Address - Phone:309-533-2147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007842101YP2500X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling