Provider Demographics
NPI:1942376652
Name:HOEKSTRA, STEVEN R (MA LCPC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:R
Last Name:HOEKSTRA
Suffix:
Gender:M
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 162ND ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2237
Mailing Address - Country:US
Mailing Address - Phone:708-339-2769
Mailing Address - Fax:708-339-6776
Practice Address - Street 1:401 E 162ND ST
Practice Address - Street 2:SUITE 109
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2237
Practice Address - Country:US
Practice Address - Phone:708-339-2769
Practice Address - Fax:708-339-6776
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635061OtherBCBS OF IL