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General NPI Number Information
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NPI Number | 1871034447
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Entity Type | Organization
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Legal Business Name | MICHELLE DELAROSA THERAPY, LCPC, LLC
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 800 E NORTHWEST HWY SUITE 422
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City | PALATINE
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State | IL
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Zip | 60074-6519
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Country | US
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Telephone | 847-302-1196
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Fax | 847-485-7142
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Provider Business Mailing Address
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Address Line | 800 E NORTHWEST HWY SUITE 422
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City | PALATINE
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State | IL
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Zip | 60074-6519
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Country | US
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Telephone | 847-302-1196
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Fax | 847-485-7142
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MICHELLE DELAROSA
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Credential | LCPC
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Telephone | 847-302-1196
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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 | 180003905
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License Number State | IL
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