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DR. CHRISTINE MICHELLE MENDENHALL PSYD.LCPCCADCMISA NPI 1679717706


NPI Information

NPI: 1679717706
Provider Name: DR. CHRISTINE MICHELLE MENDENHALL, PSYD.,LCPC,CADC,MISA
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
14127 LEAVITT AVE
BLUE ISLAND, IL
ZIP 60406
Phone: (708) 275-5824
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DR. Christine Michelle Mendenhall, PSYD.,LCPC,CADC,MISA is a professional counselor in Blue Island, IL. DR. Christine Michelle Mendenhall, PSYD.,LCPC,CADC,MISA NPI is 1679717706. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14127 LEAVITT AVE
BLUE ISLAND, IL
ZIP 60406-242
Phone: (708) 275-5824

The enumeration date for this NPI number is 4/20/2009 and was last updated on 5/27/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)21415ILLINOISNo
2101YP2500XCounselorProfessional180.007149ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1$$$$$$$$$001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.