Provider Demographics
NPI:1487164471
Name:HENDRIX, JEAN (LCPC)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:HENDRIX
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 1:1359 FOX HILL CT
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-8942
Mailing Address - Country:US
Mailing Address - Phone:630-907-7619
Mailing Address - Fax:
Practice Address - Street 1:1185 DUNDEE AVE STE E1
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2233
Practice Address - Country:US
Practice Address - Phone:847-608-8570
Practice Address - Fax:847-608-8572
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional