Provider Demographics
NPI:1659584969
Name:STEPHENS, JAMES ERIC (LCPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ERIC
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3903
Mailing Address - Country:US
Mailing Address - Phone:312-285-3415
Mailing Address - Fax:
Practice Address - Street 1:5148 S DREXEL AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3876
Practice Address - Country:US
Practice Address - Phone:312-826-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional