Provider Demographics
NPI:1740737253
Name:HELENE A. JACQUES, LCPC, PC
Entity Type:Organization
Organization Name:HELENE A. JACQUES, LCPC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-341-1079
Mailing Address - Street 1:855 WESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-9010
Mailing Address - Country:US
Mailing Address - Phone:630-341-1079
Mailing Address - Fax:
Practice Address - Street 1:1010 JORIE BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4446
Practice Address - Country:US
Practice Address - Phone:630-341-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty