Provider Demographics
NPI:1861657140
Name:DOWNS, STEPHANIE ANNE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:DOWNS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 W THORNDALE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3323
Mailing Address - Country:US
Mailing Address - Phone:239-438-2843
Mailing Address - Fax:
Practice Address - Street 1:4801 W PETERSON AVE STE 525
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5731
Practice Address - Country:US
Practice Address - Phone:773-286-3100
Practice Address - Fax:773-777-7543
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-004303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional