Blyth, Deanna R

Blyth, Deanna R is an individual health care provider with primary practice located at 3513 Cricket Ave , New Lenox IL 60451-9785. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Blyth, Deanna R can be contacted via phone (815) 351-0208.

Contact Information

Primary practice address
3513 Cricket Ave New Lenox IL 60451-9785
Phone: (815) 351-0208
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178015369 Illinois

Profile Details

NPI number 1295370930
LBN Legal business name Blyth, Deanna R
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2019
Last updated Nov 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295370930 NPPES
Illinois Other 178015369 ILLINOIS

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