Provider Demographics
NPI:1063600112
Name:HUYSER, KEVIN JOHN (MA, LCPC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JOHN
Last Name:HUYSER
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 1:7300 W COLLEGE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1183
Mailing Address - Country:US
Mailing Address - Phone:708-448-0884
Mailing Address - Fax:708-448-0594
Practice Address - Street 1:7300 W COLLEGE DR STE 203
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1183
Practice Address - Country:US
Practice Address - Phone:708-448-0884
Practice Address - Fax:708-448-0594
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional