Provider Demographics
NPI:1770113979
Name:STIMAGE, SHENEKIA (LPC)
Entity type:Individual
Prefix:
First Name:SHENEKIA
Middle Name:
Last Name:STIMAGE
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 1:8765 W HIGGINS RD STE 450
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-4172
Mailing Address - Country:US
Mailing Address - Phone:773-391-3714
Mailing Address - Fax:
Practice Address - Street 1:1260 IROQUOIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8547
Practice Address - Country:US
Practice Address - Phone:773-391-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional