Provider Demographics
NPI:1649497686
Name:KLECHA, DEBORAH M (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:KLECHA
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 W FARWELL AVE # 2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-3605
Mailing Address - Country:US
Mailing Address - Phone:773-495-9085
Mailing Address - Fax:
Practice Address - Street 1:1599 MAPLE AVE
Practice Address - Street 2:HHCS-RAFAEL CENTER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4367
Practice Address - Country:US
Practice Address - Phone:847-491-1122
Practice Address - Fax:847-570-6083
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL24176101YA0400X
IL178004312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)