Provider Demographics
NPI:1497032296
Name:HUMPHREY, DENNIS R (LCPC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:R
Last Name:HUMPHREY
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 SLINGERLAND
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2351
Mailing Address - Country:US
Mailing Address - Phone:847-302-4492
Mailing Address - Fax:
Practice Address - Street 1:2500 W. HIGGINS RD.
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7209
Practice Address - Country:US
Practice Address - Phone:847-302-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional