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General NPI Number Information
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NPI Number | 1114542040
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Entity Type | Individual
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Provider Name | STACI E. ZERPHEY LCPC, ATR
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Gender | Female
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 1011 LAKE ST STE 425
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City | OAK PARK
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State | IL
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Zip | 60301-1163
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Country | US
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Telephone | 312-870-0120
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Fax | 312-819-2080
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Provider Business Mailing Address
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Address Line | 1011 LAKE ST STE 425
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City | OAK PARK
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State | IL
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Zip | 60301-1163
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Country | US
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Telephone | 312-870-0120
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Fax | 312-819-2080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 18-487
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.013734
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License Number State | IL
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