Healthcare Provider Details

I. General information

NPI: 1992133706
Provider Name (Legal Business Name): ELIZABETH CIPRIANO MS, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ROOSEVELT RD
GLEN ELLYN IL
60137-2600
US

IV. Provider business mailing address

655 BREMER CT
GLEN ELLYN IL
60137-5022
US

V. Phone/Fax

Practice location:
  • Phone: 630-858-1353
  • Fax:
Mailing address:
  • Phone: 630-606-1031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number2574163
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.012178
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: