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General NPI Number Information
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NPI Number | 1588208631
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Entity Type | Individual
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Provider Name | ELIZABETH ANDERSON LPC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2019
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 1300 IROQUOIS AVE STE 145
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City | NAPERVILLE
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State | IL
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Zip | 60563-1389
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Country | US
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Telephone | 630-797-9192
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Fax |
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Provider Business Mailing Address
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Address Line | 14130 S HILLTOP LN UNIT 205
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City | LOCKPORT
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State | IL
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Zip | 60441-4982
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Country | US
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Telephone | 815-302-8497
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178015364
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License Number State | IL
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