Individual
MISS ANN LUCIA CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LCSW
Contact information
Practice address
206 N RANDOLPH ST STE 401, CHAMPAIGN, IL 61820-8812
(217) 390-2917
(217) 355-1866
Mailing address
2203 S ANDERSON ST, URBANA, IL 61801-6711
(217) 390-2917
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.006166
IL
104100000X
Social Worker
150.004709
IL
1041C0700X
Clinical Social Worker
Primary
149.012797
IL
1041S0200X
School Social Worker
1465346
IL
Other
Enumeration date
12/08/2006
Last updated
02/18/2021
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