Provider Demographics
NPI:1871393900
Name:FAVELA, REBECCA IVETTE (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:IVETTE
Last Name:FAVELA
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 W 66TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3248
Mailing Address - Country:US
Mailing Address - Phone:708-543-1678
Mailing Address - Fax:
Practice Address - Street 1:3020 WOODCREEK DR STE A2
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5416
Practice Address - Country:US
Practice Address - Phone:630-797-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional