Provider Demographics
NPI:1588820302
Name:OUWINGA, ANNE E (LCPC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:E
Last Name:OUWINGA
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 1:1212 N LASALLE ST
Mailing Address - Street 2:APT. 2108
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8027
Mailing Address - Country:US
Mailing Address - Phone:708-574-2004
Mailing Address - Fax:
Practice Address - Street 1:935 175TH ST STE 300
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2073
Practice Address - Country:US
Practice Address - Phone:708-574-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional