Provider Demographics
NPI:1881141711
Name:DRURY, HEATHER ANNE (LCPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:DRURY
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 1:100 E MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2744
Mailing Address - Country:US
Mailing Address - Phone:630-643-0496
Mailing Address - Fax:
Practice Address - Street 1:100 E MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2744
Practice Address - Country:US
Practice Address - Phone:630-643-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008204101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional