Provider Demographics
NPI:1396262333
Name:SENIOR, CHRISSY (MA, LPC)
Entity type:Individual
Prefix:
First Name:CHRISSY
Middle Name:
Last Name:SENIOR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 MARLBORO LN APT 113
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-2285
Mailing Address - Country:US
Mailing Address - Phone:815-503-1044
Mailing Address - Fax:
Practice Address - Street 1:620 WING ST STE 3
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2800
Practice Address - Country:US
Practice Address - Phone:847-450-0524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health