Provider Demographics
NPI:1396028130
Name:CAUGHEY, SUMIAYA ASSEL (LCPC)
Entity Type:Individual
Prefix:
First Name:SUMIAYA
Middle Name:ASSEL
Last Name:CAUGHEY
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 1:120 N WEST RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2120
Mailing Address - Country:US
Mailing Address - Phone:517-974-1329
Mailing Address - Fax:
Practice Address - Street 1:120 N WEST RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2120
Practice Address - Country:US
Practice Address - Phone:517-974-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health