Provider Demographics
NPI:1306622188
Name:JENNIFER STEC LCPC, LLC
Entity type:Organization
Organization Name:JENNIFER STEC LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEC
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-870-0366
Mailing Address - Street 1:10127 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1927
Mailing Address - Country:US
Mailing Address - Phone:312-870-0366
Mailing Address - Fax:
Practice Address - Street 1:10127 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1927
Practice Address - Country:US
Practice Address - Phone:312-870-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health