Provider Demographics
NPI:1588014906
Name:ALLTOP, TANYA (LCPC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:ALLTOP
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16151 WEBER RD STE LL10
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0863
Mailing Address - Country:US
Mailing Address - Phone:815-782-8263
Mailing Address - Fax:815-556-8140
Practice Address - Street 1:16151 WEBER RD STE LL10
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-0863
Practice Address - Country:US
Practice Address - Phone:815-782-8263
Practice Address - Fax:815-556-8140
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional