Provider Demographics
NPI:1619007481
Name:O'HALLORAN, DOROTHY (LCPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:O'HALLORAN
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 1:615 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5039
Mailing Address - Country:US
Mailing Address - Phone:630-246-6988
Mailing Address - Fax:630-246-6988
Practice Address - Street 1:615 W FRONT ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5039
Practice Address - Country:US
Practice Address - Phone:630-246-6988
Practice Address - Fax:630-246-6988
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional