Provider Demographics
NPI:1013259944
Name:CHANDRA, CHARU SAXENA (LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:CHARU
Middle Name:SAXENA
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6433 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5414
Mailing Address - Country:US
Mailing Address - Phone:630-400-8597
Mailing Address - Fax:630-654-4643
Practice Address - Street 1:1142 CHICAGO AVE STE 2E
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1837
Practice Address - Country:US
Practice Address - Phone:312-479-4779
Practice Address - Fax:708-779-6131
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008500101YM0800X, 101YP2500X
WI10662125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health