Healthcare Provider Details

I. General information

NPI: 1033740071
Provider Name (Legal Business Name): GINA MERCEDES CROVETTI LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 N MILL ST STE 100
NAPERVILLE IL
60563-2047
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-646-8000
  • Fax:
Mailing address:
  • Phone: 847-982-3167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180014873
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number18-356
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: