Provider Demographics
NPI:1548464159
Name:HEWETT, KEN L (LCPC)
Entity type:Individual
Prefix:MR
First Name:KEN
Middle Name:L
Last Name:HEWETT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W WILSON ST
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4917
Mailing Address - Country:US
Mailing Address - Phone:847-363-1900
Mailing Address - Fax:
Practice Address - Street 1:431 N QUENTIN RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-4832
Practice Address - Country:US
Practice Address - Phone:847-776-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional