Healthcare Provider Details

I. General information

NPI: 1144055484
Provider Name (Legal Business Name): RACHEL KOZIOL MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL MICHALSKI LCPC

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 5TH AVE STE 109
NAPERVILLE IL
60563-3173
US

IV. Provider business mailing address

2735 HASSERT BLVD STE 135, #2163
NAPERVILLE IL
60564-5205
US

V. Phone/Fax

Practice location:
  • Phone: 331-444-2389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180016799
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: