Provider Demographics
NPI:1801087697
Name:NAUGHTON, NANCY ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:NAUGHTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:2055 W ILES AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7001
Mailing Address - Country:US
Mailing Address - Phone:217-971-5848
Mailing Address - Fax:217-787-0283
Practice Address - Street 1:29 W HAZEL DELL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-5277
Practice Address - Country:US
Practice Address - Phone:217-585-6786
Practice Address - Fax:217-585-6786
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional