Provider Demographics
NPI:1639302110
Name:WAKELY, SHEILA (LCPC, NCC CADC, CEDS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:WAKELY
Suffix:
Gender:F
Credentials:LCPC, NCC CADC, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28W530 BATAVIA RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3022
Mailing Address - Country:US
Mailing Address - Phone:630-362-5385
Mailing Address - Fax:630-876-0608
Practice Address - Street 1:28W530 BATAVIA RD STE 1
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3022
Practice Address - Country:US
Practice Address - Phone:630-362-5385
Practice Address - Fax:630-876-0608
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007060101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor