Provider Demographics
NPI:1538328638
Name:HEGEMAN, KURT E (LCPC)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:E
Last Name:HEGEMAN
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 1:6 DUNLAP CT
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9501
Mailing Address - Country:US
Mailing Address - Phone:217-378-4848
Mailing Address - Fax:
Practice Address - Street 1:6 DUNLAP CT
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9501
Practice Address - Country:US
Practice Address - Phone:217-378-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL18232101YA0400X
IL180003933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)