Healthcare Provider Details

I. General information

NPI: 1790600609
Provider Name (Legal Business Name): LAURA A CRUMPLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 W VALLETTE ST
ELMHURST IL
60126-4419
US

IV. Provider business mailing address

9S583 LORRAINE DR
WILLOWBROOK IL
60527-7066
US

V. Phone/Fax

Practice location:
  • Phone: 844-984-7252
  • Fax:
Mailing address:
  • Phone: 844-984-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.023393
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: