Healthcare Provider Details

I. General information

NPI: 1275258725
Provider Name (Legal Business Name): ANA BRIONES LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S MICHIGAN AVE STE 1450
CHICAGO IL
60603-6176
US

IV. Provider business mailing address

122 S MICHIGAN AVE STE 1450
CHICAGO IL
60603-6176
US

V. Phone/Fax

Practice location:
  • Phone: 312-786-4990
  • Fax:
Mailing address:
  • Phone: 312-786-4990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178017953
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.017431
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: