Healthcare Provider Details

I. General information

NPI: 1750913323
Provider Name (Legal Business Name): RENSY MATHEW LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 N ARLINGTON HEIGHTS RD STE 205E
ARLINGTON HEIGHTS IL
60004-3958
US

IV. Provider business mailing address

1655 N ARLINGTON HEIGHTS RD STE 205E
ARLINGTON HEIGHTS IL
60004-3958
US

V. Phone/Fax

Practice location:
  • Phone: 224-735-3935
  • Fax:
Mailing address:
  • Phone: 224-735-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180015873
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: