Healthcare Provider Details

I. General information

NPI: 1275416182
Provider Name (Legal Business Name): ANDRIA LAMPKIN, LCPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11107 S LONGWOOD DR
CHICAGO IL
60643-4008
US

IV. Provider business mailing address

11107 S LONGWOOD DR
CHICAGO IL
60643-4008
US

V. Phone/Fax

Practice location:
  • Phone: 708-317-8698
  • Fax:
Mailing address:
  • Phone: 708-317-8698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. ANDRIA N LAMPKIN
Title or Position: THERAPIST/OWNER
Credential: MA, LCPC
Phone: 708-317-8698