Provider Demographics
NPI:1902302995
Name:ACEVEDO, ALEXIS (LPC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 N WHIPPLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-2504
Mailing Address - Country:US
Mailing Address - Phone:773-961-5533
Mailing Address - Fax:
Practice Address - Street 1:70 E LAKE ST STE 1220
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5939
Practice Address - Country:US
Practice Address - Phone:708-553-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178021391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional