Provider Demographics
NPI:1770969396
Name:CORSUN-ASCHER, JONAH (LCPC)
Entity type:Individual
Prefix:
First Name:JONAH
Middle Name:
Last Name:CORSUN-ASCHER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 HIGHLAND AVE
Mailing Address - Street 2:NORTH PAVILION, 2ND FLOOR
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1500
Mailing Address - Country:US
Mailing Address - Phone:630-275-6179
Mailing Address - Fax:630-963-8745
Practice Address - Street 1:3815 HIGHLAND AVE
Practice Address - Street 2:NORTH PAVILION, 2ND FLOOR
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1500
Practice Address - Country:US
Practice Address - Phone:630-275-6179
Practice Address - Fax:630-963-8745
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008332101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor