Provider Demographics
NPI:1700281235
Name:CONTOS, THERESA JOAN (LPC)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:JOAN
Last Name:CONTOS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 SOUTH ROUTE 31
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050
Mailing Address - Country:US
Mailing Address - Phone:815-344-9443
Mailing Address - Fax:
Practice Address - Street 1:618 SOUTH ROUTE HIGHWAY 31
Practice Address - Street 2:SUITE 2
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050
Practice Address - Country:US
Practice Address - Phone:815-344-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010297101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor