Provider Demographics
NPI:1902037682
Name:FROSSARD, TAMMY LYNN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LYNN
Last Name:FROSSARD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4584 METEOR CT
Mailing Address - Street 2:
Mailing Address - City:MACHESNEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61115-2247
Mailing Address - Country:US
Mailing Address - Phone:815-985-6560
Mailing Address - Fax:815-969-8871
Practice Address - Street 1:4584 METEOR CT
Practice Address - Street 2:
Practice Address - City:MACHESNEY PARK
Practice Address - State:IL
Practice Address - Zip Code:61115-2247
Practice Address - Country:US
Practice Address - Phone:815-985-6560
Practice Address - Fax:815-969-8871
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional