Individual
MR. FREDERICK JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CADC
Contact information
Practice address
1034 30TH AVE, BELLWOOD, IL 60104-2442
(708) 328-0193
Mailing address
1034 30TH AVE, BELLWOOD, IL 60104-2442
(708) 328-0193
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178017761
IL
Other
Enumeration date
05/26/2022
Last updated
02/25/2025
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