Provider Demographics
NPI:1295281608
Name:FEFFERMAN, JOAN L (LCPC CADC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:L
Last Name:FEFFERMAN
Suffix:
Gender:F
Credentials:LCPC CADC
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:LOUISE
Other - Last Name:FEFFERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC CADC
Mailing Address - Street 1:213 W WESLEY ST STE 106D
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5135
Mailing Address - Country:US
Mailing Address - Phone:630-868-3920
Mailing Address - Fax:
Practice Address - Street 1:213 W WESLEY ST STE 106D
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5135
Practice Address - Country:US
Practice Address - Phone:630-868-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL34407101YA0400X
IL180.011604101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor