Provider Demographics
NPI:1699821876
Name:LETWAT, DAVID N (LCPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:N
Last Name:LETWAT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 N KENNICOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2069
Mailing Address - Country:US
Mailing Address - Phone:312-209-9873
Mailing Address - Fax:847-870-0446
Practice Address - Street 1:120 W EASTMAN ST STE 305
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5950
Practice Address - Country:US
Practice Address - Phone:312-209-9873
Practice Address - Fax:847-870-0446
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health