Healthcare Provider Details

I. General information

NPI: 1699328997
Provider Name (Legal Business Name): NICOLE LOCHIRCO LCPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 ROB ROY LN APT C
PROSPECT HEIGHTS IL
60070-2858
US

IV. Provider business mailing address

225 ROB ROY LN APT C
PROSPECT HEIGHTS IL
60070-2858
US

V. Phone/Fax

Practice location:
  • Phone: 773-636-9357
  • Fax:
Mailing address:
  • Phone: 773-636-9357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.013684
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number132493
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001742
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: