Provider Demographics
NPI:1619334240
Name:JIMENEZ, ARTHUR FELIPE (MS, MA, BCBA, LPC)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:FELIPE
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MS, MA, BCBA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12745 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60418-1130
Mailing Address - Country:US
Mailing Address - Phone:708-722-2384
Mailing Address - Fax:708-926-9250
Practice Address - Street 1:12745 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-1130
Practice Address - Country:US
Practice Address - Phone:708-722-2384
Practice Address - Fax:708-926-9250
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019800101YP2500X
IL1-15-18950103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty