Healthcare Provider Details

I. General information

NPI: 1609780402
Provider Name (Legal Business Name): D & D COUNSELING PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 TYLER CT
VERNON HILLS IL
60061-1325
US

IV. Provider business mailing address

401 TYLER CT
VERNON HILLS IL
60061-1325
US

V. Phone/Fax

Practice location:
  • Phone: 440-714-8822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID GRAY
Title or Position: OWNER/VICE PRESIDENT
Credential: LCPC
Phone: 440-714-8822