Healthcare Provider Details

I. General information

NPI: 1255253241
Provider Name (Legal Business Name): LUCIA DEL RINCON MARTINEZ LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E 55TH ST STE 203
CHICAGO IL
60615-5583
US

IV. Provider business mailing address

1525 E 55TH ST
CHICAGO IL
60615-5512
US

V. Phone/Fax

Practice location:
  • Phone: 773-374-3748
  • Fax:
Mailing address:
  • Phone: 773-374-3748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.016948
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: