Provider Demographics
NPI:1417041054
Name:DE LOS SANTOS, LINDSEY (LCPC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:DE LOS SANTOS
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 1:40W787 DILLONFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60119
Mailing Address - Country:US
Mailing Address - Phone:630-677-4987
Mailing Address - Fax:
Practice Address - Street 1:825 W STATE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2080
Practice Address - Country:US
Practice Address - Phone:630-677-4987
Practice Address - Fax:630-232-4019
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional