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General NPI Number Information
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NPI Number | 1184387359
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Entity Type | Individual
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Provider Name | GUYLAINE LUCILLE HERZIG MS, MA, LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 900 SKOKIE BLVD STE 255
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City | NORTHBROOK
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State | IL
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Zip | 60062-4054
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Country | US
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Telephone | 312-870-0120
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 SOUTH BLVD
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City | EVANSTON
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State | IL
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Zip | 60202-2751
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Country | US
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Telephone | 773-470-8324
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.013208
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.013208
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License Number State | IL
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