Provider Demographics
NPI:1760605448
Name:RHEW, JACQUELINE A (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:A
Last Name:RHEW
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1389 EDDY LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2959
Mailing Address - Country:US
Mailing Address - Phone:847-668-2842
Mailing Address - Fax:
Practice Address - Street 1:610 CRYSTAL POINT DR STE 3
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1400
Practice Address - Country:US
Practice Address - Phone:815-477-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178002848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional