Provider Demographics
NPI:1942390653
Name:IYER, RAJASHREE (MS/LCPC/NCC)
Entity type:Individual
Prefix:MRS
First Name:RAJASHREE
Middle Name:
Last Name:IYER
Suffix:
Gender:F
Credentials:MS/LCPC/NCC
Other - Prefix:MRS
Other - First Name:RAJASHREE
Other - Middle Name:
Other - Last Name:IYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS/LCPC/NCC
Mailing Address - Street 1:107 SHANNON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-9463
Mailing Address - Country:US
Mailing Address - Phone:309-745-3730
Mailing Address - Fax:
Practice Address - Street 1:1820 N STERLING AVE
Practice Address - Street 2:
Practice Address - City:WEST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-6433
Practice Address - Country:US
Practice Address - Phone:309-212-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional