Provider Demographics
NPI:1255743654
Name:HERRERA, LAUREN (MA, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4014
Mailing Address - Country:US
Mailing Address - Phone:630-272-5912
Mailing Address - Fax:
Practice Address - Street 1:10735 S CICERO AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-5400
Practice Address - Country:US
Practice Address - Phone:773-424-0001
Practice Address - Fax:708-424-1394
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional