| Doctor Name: | MRS. ELAINE A HUMPHREY |
| NPI Number: | 1457533994 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180 001100 |
| Business Practice Address: | 137 E College St Kewanee, IL - 61443 |
| Business Phone Number: | 3098524331 |
| Business Fax Number: | |
| Mailing Address: | 100 S College Ave, GENESCO |
| State: | IL |
| Postal Code: | 61254 |
| Phone Number: | 3099443203 |
| Fax Number: | |
| NPI Enumeration Date: | 11/27/2007 |
| NPI Last Update Date: | 04/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180 001100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |