Forrest, Marcia Gleaves

Forrest, Marcia Gleaves is an sole proprietor health care provider with primary practice located at 516 N Main St Suite C, Glen Ellyn IL 60137-5175. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Forrest, Marcia Gleaves can be contacted via phone (630) 627-2588.

Contact Information

Primary practice address
516 N Main St Suite C Glen Ellyn IL 60137-5175
Phone: (630) 627-2588
Fax: (630) 980-9242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X Illinois

Profile Details

NPI number 1104833722
LBN Legal business name Forrest, Marcia Gleaves
Credentials LCPC, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

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 1104833722 NPPES
Illinois Other 0002232107 BCBS PROVIDER #

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