Individual
MS. ISIE IERISI BARCLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
218 MILLINGTON WAY, ST CHARLES, IL 60174-1180
(630) 232-0921
Mailing address
218 MILLINGTON WAY, ST CHARLES, IL 60174-1180
(630) 232-0921
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
180-000984
IL
101YM0800X
Mental Health Counselor
180-000984
IL
101YP2500X
Professional Counselor
Primary
180-000984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04522948
BCBS PROVIDER ID PIN #
IL
01
—
180-0000984
LCPC STATE LICENSE #
IL
Enumeration date
07/23/2006
Last updated
08/30/2020
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