Provider Demographics
NPI:1992927552
Name:LAWRENCE, THERESE M (LCPC)
Entity type:Individual
Prefix:MISS
First Name:THERESE
Middle Name:M
Last Name:LAWRENCE
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 1:2216 HILLSBORO CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-6733
Mailing Address - Country:US
Mailing Address - Phone:630-935-0611
Mailing Address - Fax:
Practice Address - Street 1:34 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1388
Practice Address - Country:US
Practice Address - Phone:815-372-8950
Practice Address - Fax:815-372-8960
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor