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General NPI Number Information
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NPI Number | 1720901374
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Entity Type | Organization
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Legal Business Name | STUDIO TWENTY THREE PLLC
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 917 VOSE DR APT 403
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City | GURNEE
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State | IL
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Zip | 60031-3192
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Country | US
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Telephone | 872-265-1473
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Fax |
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR STE 110-1449
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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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 | OWNER AND LICENSED PSYCHOTHERAPIST
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Name | LOLA MARIE CICCONE DAMATO
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Credential | LCPC, NCC
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Telephone | 872-265-1473
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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