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General NPI Number Information
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NPI Number | 1609123447
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Entity Type | Individual
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Provider Name | HEATHER STANLEY MA, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 13246 S ROUTE 59 STE 216
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City | PLAINFIELD
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State | IL
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Zip | 60585-9805
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Country | US
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Telephone | 815-701-9227
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Fax | 815-277-1275
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Provider Business Mailing Address
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Address Line | 13246 S ROUTE 59 STE 216
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City | PLAINFIELD
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State | IL
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Zip | 60585-9805
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Country | US
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Telephone | 815-701-9227
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Fax | 815-277-1275
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180008340
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License Number State | IL
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