Healthcare Provider Details

I. General information

NPI: 1538070354
Provider Name (Legal Business Name): SIERA LAVOY LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 ROOSEVELT RD # 1002
GLEN ELLYN IL
60137-5734
US

IV. Provider business mailing address

539 ROOSEVELT RD # 1002
GLEN ELLYN IL
60137-5734
US

V. Phone/Fax

Practice location:
  • Phone: 331-666-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180017444
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: