Healthcare Provider Details

I. General information

NPI: 1952830200
Provider Name (Legal Business Name): BRITTNEY ANN SEGOVIANO LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 12/01/2024
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 OAKWOOD LN
SOUTH ELGIN IL
60177-3278
US

IV. Provider business mailing address

686 OAKWOOD LN
SOUTH ELGIN IL
60177-3278
US

V. Phone/Fax

Practice location:
  • Phone: 847-400-6891
  • Fax:
Mailing address:
  • Phone: 847-400-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180010656
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: