Provider Demographics
NPI:1699464057
Name:WORKHEISER, THERESA NICOLE (LPCC)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:NICOLE
Last Name:WORKHEISER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-3042
Mailing Address - Country:US
Mailing Address - Phone:309-368-8603
Mailing Address - Fax:
Practice Address - Street 1:1030 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-3042
Practice Address - Country:US
Practice Address - Phone:309-857-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional