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General NPI Number Information
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NPI Number | 1255858668
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Entity Type | Individual
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Provider Name | KRISTIN CIZEK LPC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 1041 HIGHWAY 36 STE 206
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-2535
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Country | US
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Telephone | 732-982-2888
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Fax | 847-859-5885
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Provider Business Mailing Address
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Address Line | 175 E HAWTHORN PKWY STE 235
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City | VERNON HILLS
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State | IL
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Zip | 60061-1454
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Country | US
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Telephone | 847-868-3435
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Fax | 847-859-5885
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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 | 37AC00348600
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License Number State | NJ
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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 | 37PC00721300
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License Number State | NJ
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