Provider Demographics
NPI:1558809848
Name:REMMERT, STEPHEN A (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:REMMERT
Suffix:
Gender:M
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8834 W 140TH ST
Mailing Address - Street 2:1B
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2214
Mailing Address - Country:US
Mailing Address - Phone:815-545-2214
Mailing Address - Fax:
Practice Address - Street 1:9944 S ROBERTS RD
Practice Address - Street 2:SUITE 111
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1555
Practice Address - Country:US
Practice Address - Phone:708-586-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health