Provider Demographics
NPI:1972837714
Name:MORHEAD, WILLIE B (LCPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:B
Last Name:MORHEAD
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:MR
Other - First Name:WILLIE
Other - Middle Name:B
Other - Last Name:MORHEAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:4220 TIGER LILY LN
Mailing Address - Street 2:UNIT 402
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-9630
Mailing Address - Country:US
Mailing Address - Phone:903-422-9797
Mailing Address - Fax:
Practice Address - Street 1:4220 TIGER LILY LN
Practice Address - Street 2:UNIT 402
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-9630
Practice Address - Country:US
Practice Address - Phone:903-422-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-27
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional