Provider Demographics
NPI:1760843403
Name:WILCOX, YOLANDA (LPC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:WILCOX
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 1:23 CALENDAR CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2365
Mailing Address - Country:US
Mailing Address - Phone:708-617-9336
Mailing Address - Fax:
Practice Address - Street 1:23 CALENDAR CT
Practice Address - Street 2:SUITE 201
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2365
Practice Address - Country:US
Practice Address - Phone:708-617-9336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional