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General NPI Number Information
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NPI Number | 1811549785
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Entity Type | Individual
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Provider Name | CAROLYN J LEIBOVITZ LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 200 N FAIRWAY DR STE 208
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City | VERNON HILLS
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State | IL
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Zip | 60061-1803
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Country | US
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Telephone | 847-996-6666
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Fax | 847-996-6665
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Provider Business Mailing Address
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Address Line | 7351 E LOWRY BLVD STE 200
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City | DENVER
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State | CO
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Zip | 80230-6083
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Country | US
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Telephone | 866-295-5455
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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 | 180.011978
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License Number State | IL
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