Provider Demographics
NPI:1457435208
Name:CARRERA, HEDY E (LCPC, BCPC, EAP)
Entity Type:Individual
Prefix:MS
First Name:HEDY
Middle Name:E
Last Name:CARRERA
Suffix:
Gender:F
Credentials:LCPC, BCPC, EAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 CRAWFORD AVE STE 22
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4983
Mailing Address - Country:US
Mailing Address - Phone:773-808-8345
Mailing Address - Fax:847-492-1255
Practice Address - Street 1:2550 CRAWFORD AVE STE 22
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4983
Practice Address - Country:US
Practice Address - Phone:773-808-8345
Practice Address - Fax:847-492-1255
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional