Provider Demographics
NPI:1508069139
Name:SCHURMAN, JENNIFER BETH (MA, LCPC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:BETH
Last Name:SCHURMAN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:BETH
Other - Last Name:LESLIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3523 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1137
Mailing Address - Country:US
Mailing Address - Phone:773-810-9899
Mailing Address - Fax:
Practice Address - Street 1:3523 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1137
Practice Address - Country:US
Practice Address - Phone:773-810-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional