Provider Demographics
NPI:1427742766
Name:CONTRERAS, JESSICA MARLENE (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARLENE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-4342
Mailing Address - Country:US
Mailing Address - Phone:708-220-3550
Mailing Address - Fax:
Practice Address - Street 1:17 N WABASH AVE STE 515
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4818
Practice Address - Country:US
Practice Address - Phone:313-509-7340
Practice Address - Fax:224-935-9030
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011650101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor