Provider Demographics
NPI:1285796557
Name:HESS, ALLEGRA H (LCPC LIC CLINICAL PR)
Entity type:Individual
Prefix:MS
First Name:ALLEGRA
Middle Name:H
Last Name:HESS
Suffix:
Gender:F
Credentials:LCPC LIC CLINICAL PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 SO WEST ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-668-8710
Mailing Address - Fax:630-668-8779
Practice Address - Street 1:618 SO WEST ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187
Practice Address - Country:US
Practice Address - Phone:630-668-8710
Practice Address - Fax:630-668-8779
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor