Provider Demographics
NPI:1013138643
Name:OLOWOPOPO, SHERIFAT (LCPC)
Entity type:Individual
Prefix:MS
First Name:SHERIFAT
Middle Name:
Last Name:OLOWOPOPO
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 1:8339 S. PHILLIPS AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617
Mailing Address - Country:US
Mailing Address - Phone:773-447-4408
Mailing Address - Fax:773-651-5418
Practice Address - Street 1:8541 S. STATE STREET
Practice Address - Street 2:CMHC SUITE 10
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619
Practice Address - Country:US
Practice Address - Phone:773-651-4954
Practice Address - Fax:773-651-5418
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health