Provider Demographics
NPI:1912319146
Name:BARGEWELL, TERESEA (LPC, MA)
Entity Type:Individual
Prefix:MRS
First Name:TERESEA
Middle Name:
Last Name:BARGEWELL
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 SUSANNA WAY
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0842
Mailing Address - Country:US
Mailing Address - Phone:815-725-2006
Mailing Address - Fax:
Practice Address - Street 1:1049 E. LINCOLN HWY
Practice Address - Street 2:DECISION POINT COUNSELING AND CAREER CENTER
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:312-218-8483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009393101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional