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General NPI Number Information
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NPI Number | 1427532753
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Entity Type | Individual
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Provider Name | GINA MARIE MENCONI LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1300 IROQUOIS AVE STE 145
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City | NAPERVILLE
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State | IL
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Zip | 60563-1389
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Country | US
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Telephone | 630-305-0464
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Fax | 630-305-0211
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Provider Business Mailing Address
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Address Line | 208 W EVERGREEN ST
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City | WHEATON
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State | IL
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Zip | 60187-5202
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Country | US
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Telephone | 708-209-9924
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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 | 178.005280
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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 | 180.012726
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License Number State | IL
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