Provider Demographics
NPI:1659793545
Name:SEWICK, BRUCE (LCPC, RDDP, CADC)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:SEWICK
Suffix:
Gender:M
Credentials:LCPC, RDDP, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2563
Mailing Address - Country:US
Mailing Address - Phone:847-451-0330
Mailing Address - Fax:847-451-1652
Practice Address - Street 1:10001 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2563
Practice Address - Country:US
Practice Address - Phone:847-451-0330
Practice Address - Fax:847-451-1652
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IL180003570101Y00000X
IL27610101YA0400X
IL180-003570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)