Corliss Ivy, LCPC

NPI #1811584261 in Zion, Illinois

Provider Information

NPI Number: 1811584261
Entity Type: Individual
Name: Corliss Ivy, LCPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LCPC
Enumeration Date: Dec 30, 2020
Last Updated: Dec 9, 2021

Practice Location

Address: 2520 ELISHA AVE
City: Zion
State: Illinois
ZIP Code: 60099
Phone: (224) 707-0146

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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