Provider Demographics
NPI:1861797623
Name:LAWSON, JENNIFER LESLEY (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LESLEY
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1125 TRI STATE PKWY
Mailing Address - Street 2:SUITE 720
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-9177
Mailing Address - Country:US
Mailing Address - Phone:847-245-6588
Mailing Address - Fax:847-855-1609
Practice Address - Street 1:1125 TRI STATE PKWY
Practice Address - Street 2:SUITE 720
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-9177
Practice Address - Country:US
Practice Address - Phone:847-245-6588
Practice Address - Fax:847-855-1609
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL25043275697101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor