Provider Demographics
NPI:1720605868
Name:BARRY, ERIN THERESE (LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:THERESE
Last Name:BARRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:THERESE
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:7510 W UTE LN
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2048
Mailing Address - Country:US
Mailing Address - Phone:708-368-0557
Mailing Address - Fax:
Practice Address - Street 1:222 VOLLMER RD STE AA2
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1664
Practice Address - Country:US
Practice Address - Phone:630-281-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-05
Last Update Date:2020-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health