Provider Demographics
NPI:1346612389
Name:ANDRESS, CAMILLE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ELIZABETH
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 W HALF DAY RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6547
Mailing Address - Country:US
Mailing Address - Phone:847-821-9346
Mailing Address - Fax:
Practice Address - Street 1:34121 N US HIGHWAY 45
Practice Address - Street 2:SUITE 221
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1768
Practice Address - Country:US
Practice Address - Phone:872-588-0912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011434101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor