Provider Demographics
NPI:1629787148
Name:HERNANDEZ, ARACELY (MA, NCC)
Entity type:Individual
Prefix:MRS
First Name:ARACELY
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:ARACELY
Other - Middle Name:
Other - Last Name:DE LA LUZ LANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 SKOKIE BLVD STE 255
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4054
Mailing Address - Country:US
Mailing Address - Phone:312-870-0120
Mailing Address - Fax:312-819-2080
Practice Address - Street 1:900 SKOKIE BLVD STE 255
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4054
Practice Address - Country:US
Practice Address - Phone:312-870-0120
Practice Address - Fax:312-819-2080
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional