Provider Demographics
NPI:1992978506
Name:FUHS, DIANE (MA, LCPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:FUHS
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ILLINOIS ST STE 200
Mailing Address - Street 2:PO BOX 3176
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1867
Mailing Address - Country:US
Mailing Address - Phone:847-922-4128
Mailing Address - Fax:847-841-3682
Practice Address - Street 1:100 ILLINOIS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1866
Practice Address - Country:US
Practice Address - Phone:847-922-4128
Practice Address - Fax:847-841-3682
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006313101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional