Provider Demographics
NPI:1407558026
Name:ATHY, CIARA JOY (MA, LPC, ATR)
Entity Type:Individual
Prefix:MISS
First Name:CIARA
Middle Name:JOY
Last Name:ATHY
Suffix:
Gender:F
Credentials:MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-7402
Mailing Address - Country:US
Mailing Address - Phone:630-418-9239
Mailing Address - Fax:
Practice Address - Street 1:63 DEBORAH DR
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-7402
Practice Address - Country:US
Practice Address - Phone:630-418-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016868101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor