Provider Demographics
NPI:1790127439
Name:NEMETH, JEFFREY MARTYN (LPC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MARTYN
Last Name:NEMETH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W ROMEO RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1521
Mailing Address - Country:US
Mailing Address - Phone:815-838-2690
Mailing Address - Fax:
Practice Address - Street 1:215 W ROMEO RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1521
Practice Address - Country:US
Practice Address - Phone:815-838-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional