Provider Demographics
NPI:1689220675
Name:STEPHENS, ALLISON JOY (LPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOY
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 W 127TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:ALSIP
Mailing Address - State:IL
Mailing Address - Zip Code:60803-1943
Mailing Address - Country:US
Mailing Address - Phone:773-870-6798
Mailing Address - Fax:
Practice Address - Street 1:4041 W 127TH ST APT 6
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-1943
Practice Address - Country:US
Practice Address - Phone:773-870-6798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007033101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor