Healthcare Provider Details

I. General information

NPI: 1972899706
Provider Name (Legal Business Name): MAUREEN HERMANN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAUREEN WERRBACH

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 N AVONDALE AVE
CHICAGO IL
60631-1900
US

IV. Provider business mailing address

6321 N AVONDALE AVE STE 203
CHICAGO IL
60631-1960
US

V. Phone/Fax

Practice location:
  • Phone: 773-774-4444
  • Fax:
Mailing address:
  • Phone: 773-774-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.008003
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.006528
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: