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General NPI Number Information
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NPI Number | 1134678121
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Entity Type | Individual
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Provider Name | THERESA MAROTTA LCPC, CADC
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Gender | Female
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Dates
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Enumeration Date | 10/01/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2030 E ALGONQUIN RD STE 405
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City | SCHAUMBURG
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State | IL
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Zip | 60173-4159
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Country | US
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Telephone | 847-701-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 E ALGONQUIN RD STE 405
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City | SCHAUMBURG
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State | IL
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Zip | 60173-4159
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Country | US
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Telephone | 847-701-4191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 57253
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 18049
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180-004565
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License Number State | IL
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