Healthcare Provider Details

I. General information

NPI: 1821217498
Provider Name (Legal Business Name): STACY LYNN PERKINS SMITH MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HART RD STE 130
BARRINGTON IL
60010-2668
US

IV. Provider business mailing address

1000 HART RD STE 130
BARRINGTON IL
60010-2668
US

V. Phone/Fax

Practice location:
  • Phone: 312-810-0707
  • Fax: 847-737-5280
Mailing address:
  • Phone: 312-810-0707
  • Fax: 847-737-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180002718
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: