Provider Demographics
NPI:1215789169
Name:LEVY, ALISON LANE (LPC, CADC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LANE
Last Name:LEVY
Suffix:
Gender:F
Credentials:LPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 S PLYMOUTH CT APT 117
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2055
Mailing Address - Country:US
Mailing Address - Phone:586-662-5355
Mailing Address - Fax:
Practice Address - Street 1:2045 W NORTH AVE STE 2B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5413
Practice Address - Country:US
Practice Address - Phone:773-249-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38014101YA0400X
IL178.020071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)