Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stephanie Lynn Provis

Individual provider Mental Health Counselor · NPI 1114711165

Stephanie Lynn Provis is a Mental Health Counselor in Fox Lake, Illinois. Qualified in 2025, 1 year ago. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2025

Practice location Address checks out

34 W Grand Ave Ste 101
Fox Lake, IL 60020-1224
Phone: (847) 322-2975
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (IL)

Record details

NPI number1114711165
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 7, 2025
Last updated in NPPESApril 7, 2025
Certification dateApril 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Fox Lake