Healthcare Provider Details

I. General information

NPI: 1952068991
Provider Name (Legal Business Name): GAELLE VERNET LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2021
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1048 N RANDALL RD
AURORA IL
60506-1934
US

IV. Provider business mailing address

2112 W GALENA BLVD STE 8
AURORA IL
60506-7339
US

V. Phone/Fax

Practice location:
  • Phone: 757-270-4484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24914
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14063263-6004
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.014065
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: