Healthcare Provider Details

I. General information

NPI: 1972968311
Provider Name (Legal Business Name): NADIA GREENSPAN LPC NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 LEE ST
DES PLAINES IL
60016-4539
US

IV. Provider business mailing address

1082 PINETREE CIR N
BUFFALO GROVE IL
60089-7501
US

V. Phone/Fax

Practice location:
  • Phone: 847-219-8689
  • Fax:
Mailing address:
  • Phone: 847-219-8689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number178011518
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.011518
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: