| Doctor Name: | MS. CLEO ENOCKSON HAGEN |
| NPI Number: | 1366594921 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC, CADC |
| License Number: | 1540 |
| Business Practice Address: | 8020 W 87th St Hickory Hills, IL - 604571189 |
| Business Phone Number: | 7087414500 |
| Business Fax Number: | 7087414501 |
| Mailing Address: | 537 S Harvey Ave, OAK PARK |
| State: | IL |
| Postal Code: | 603041514 |
| Phone Number: | 7083867101 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1540 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |