Provider Demographics
NPI:1770612137
Name:BOENDER, SHEILA ADELE (MA, LCPC)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ADELE
Last Name:BOENDER
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:ADELE
Other - Last Name:BEEKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LCPC
Mailing Address - Street 1:9721 165TH ST STE 23
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-4511
Mailing Address - Country:US
Mailing Address - Phone:708-602-9425
Mailing Address - Fax:708-694-9435
Practice Address - Street 1:9721 165TH ST STE 23
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-4511
Practice Address - Country:US
Practice Address - Phone:708-602-9425
Practice Address - Fax:708-694-9435
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003880101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1720223340OtherSHEILA A. BOENDER INC.