Provider Demographics
NPI:1700478260
Name:ENTLER, MEREDITH (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:
Last Name:ENTLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1625
Mailing Address - Country:US
Mailing Address - Phone:312-752-7041
Mailing Address - Fax:
Practice Address - Street 1:155 N HUDSON ST
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1625
Practice Address - Country:US
Practice Address - Phone:312-752-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178016714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional