Provider Demographics
NPI:1386135804
Name:ACEVEDO, ISABEL (LCPC)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 SLADE AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2923
Mailing Address - Country:US
Mailing Address - Phone:765-513-7276
Mailing Address - Fax:
Practice Address - Street 1:600 SPRING HILL RING RD
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-7300
Practice Address - Country:US
Practice Address - Phone:765-513-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional