Provider Demographics
NPI:1306859582
Name:ALLISON, SETH W (LCPC)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:W
Last Name:ALLISON
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:460 N MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5176
Mailing Address - Country:US
Mailing Address - Phone:630-469-4699
Mailing Address - Fax:630-469-6911
Practice Address - Street 1:460 N MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5176
Practice Address - Country:US
Practice Address - Phone:630-469-4699
Practice Address - Fax:630-469-4911
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL180005121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional