Provider Demographics
NPI:1972689198
Name:HEFTER, TERESE ROSALYN (LCPC CMADC)
Entity type:Individual
Prefix:MS
First Name:TERESE
Middle Name:ROSALYN
Last Name:HEFTER
Suffix:
Gender:F
Credentials:LCPC CMADC
Other - Prefix:
Other - First Name:TERESE
Other - Middle Name:
Other - Last Name:FENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1731 N MARCEY
Mailing Address - Street 2:TERRY HEFTER ASSOCIATES LLC SUITE 535
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5373
Mailing Address - Country:US
Mailing Address - Phone:312-280-1166
Mailing Address - Fax:312-280-1199
Practice Address - Street 1:1731 N MARCEY
Practice Address - Street 2:TERRY HEFTER ASSOCIATES LLC SUITE 535
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5373
Practice Address - Country:US
Practice Address - Phone:312-280-1166
Practice Address - Fax:312-280-1199
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional