Healthcare Provider Details
I. General information
NPI: 1801343272
Provider Name (Legal Business Name): JOSHUA SYMBAL LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2016
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 HUNTINGTON DR N
ALGONQUIN IL
60102-4419
US
IV. Provider business mailing address
1764 WOODHAVEN DR
CRYSTAL LAKE IL
60014-1940
US
V. Phone/Fax
- Phone: 847-431-2098
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 178.018290 |
| License Number State | IL |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: