Healthcare Provider Details

I. General information

NPI: 1588482285
Provider Name (Legal Business Name): CLAIRE MANLEY LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOLLISTER DR STE 201
LIBERTYVILLE IL
60048-5266
US

IV. Provider business mailing address

1800 HOLLISTER DR STE 201
LIBERTYVILLE IL
60048-5266
US

V. Phone/Fax

Practice location:
  • Phone: 847-549-1189
  • Fax:
Mailing address:
  • Phone: 847-549-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180016307
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: