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General NPI Number Information
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NPI Number | 1386032878
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Entity Type | Individual
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Provider Name | JACLYN GRAFF LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 01/04/2020
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Provider Practice Location Address
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Address Line | 1105 CURTISS ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4694
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Country | US
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Telephone | 630-426-3495
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 BANBURY CT
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City | ST CHARLES
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State | IL
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Zip | 60174-4455
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180009467
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License Number State | IL
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