Provider Demographics
NPI:1487844700
Name:PARSLEY, AUDREY L (LCPC, DT)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:L
Last Name:PARSLEY
Suffix:
Gender:F
Credentials:LCPC, DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 N SHERIDAN RD
Mailing Address - Street 2:16G
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4879
Mailing Address - Country:US
Mailing Address - Phone:773-944-9055
Mailing Address - Fax:773-944-9066
Practice Address - Street 1:5650 N SHERIDAN RD
Practice Address - Street 2:16G
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4879
Practice Address - Country:US
Practice Address - Phone:773-944-9055
Practice Address - Fax:773-944-9066
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006248101YP2500X
IL1521719103TS0200X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist