Provider Demographics
NPI:1114542040
Name:ZERPHEY, STACI E (LCPC, ATR)
Entity type:Individual
Prefix:
First Name:STACI
Middle Name:E
Last Name:ZERPHEY
Suffix:
Gender:F
Credentials:LCPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 LAKE ST STE 425
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1163
Mailing Address - Country:US
Mailing Address - Phone:312-870-0120
Mailing Address - Fax:312-819-2080
Practice Address - Street 1:1011 LAKE ST STE 425
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1163
Practice Address - Country:US
Practice Address - Phone:312-870-0120
Practice Address - Fax:312-819-2080
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18-487221700000X
IL180.013734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist