Provider Demographics
NPI:1912981390
Name:HUNTER, DAVID C (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-2257
Mailing Address - Country:US
Mailing Address - Phone:217-549-8017
Mailing Address - Fax:
Practice Address - Street 1:506 W LINCOLN AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2453
Practice Address - Country:US
Practice Address - Phone:217-348-6281
Practice Address - Fax:217-348-6329
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health