Provider Demographics
NPI:1902006604
Name:DEMPSEY, JUDITH FAULKNER (LPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:FAULKNER
Last Name:DEMPSEY
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 1:1410 W. CHESTNUT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1910
Mailing Address - Country:US
Mailing Address - Phone:618-997-2129
Mailing Address - Fax:618-997-7972
Practice Address - Street 1:1410 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1910
Practice Address - Country:US
Practice Address - Phone:618-997-2129
Practice Address - Fax:618-997-7972
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist