Healthcare Provider Details

I. General information

NPI: 1043083744
Provider Name (Legal Business Name): ELIZABETH FRANCES BLAHA LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E OGDEN AVE
HINSDALE IL
60521-3633
US

IV. Provider business mailing address

17758 S MITCHELL LN
LOCKPORT IL
60441-4754
US

V. Phone/Fax

Practice location:
  • Phone: 708-703-0171
  • Fax:
Mailing address:
  • Phone: 708-703-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180012273
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: