Provider Demographics
NPI:1104919422
Name:SCHRAGE, LUCY HANSON (MA, LCPC, ATR)
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:HANSON
Last Name:SCHRAGE
Suffix:
Gender:F
Credentials:MA, LCPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 HOLY CROSS LN
Mailing Address - Street 2:SPECIALTY CLINIC, SUITE 5
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-3618
Mailing Address - Country:US
Mailing Address - Phone:618-980-5028
Mailing Address - Fax:618-526-2855
Practice Address - Street 1:9515 HOLY CROSS LN
Practice Address - Street 2:SPECIALTY CLINIC, SUITE 5
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-3618
Practice Address - Country:US
Practice Address - Phone:618-980-5028
Practice Address - Fax:618-526-2855
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
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