Provider Demographics
NPI:1629423850
Name:CLINE, FREDERICK III (LCPC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:CLINE
Suffix:III
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:1402 N KING EDWARD CT APT 106
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2665
Mailing Address - Country:US
Mailing Address - Phone:309-235-9699
Mailing Address - Fax:309-829-6808
Practice Address - Street 1:1402 N KING EDWARD CT APT 106
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2665
Practice Address - Country:US
Practice Address - Phone:309-235-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty