Basic Information
| Provider Information | |||||||||
| NPI: | 1922498690 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDRADE-BEKKER | ||||||||
| FirstName: | MARY ANN | ||||||||
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| Credential: | LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 730 E NORTH ST | ||||||||
| Address2: | |||||||||
| City: | MORRIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604502344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737710422 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6006 159TH ST | ||||||||
| Address2: | BUILDING C | ||||||||
| City: | OAK FOREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604522904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7085357320 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2015 | ||||||||
| LastUpdateDate: | 02/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 180009455 | IL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.