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NPI Code Detail

MEDICARE: BRIAN GARIBALDI MA, LCPC

MEDICARE: BRIAN GARIBALDI MA, LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor180.007638IL

General Provider Information

NPI Number : 1023270303
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN GARIBALDI MA, LCPC
Provider Business Mailing Address
First Line : 3345 N ARLINGTON HEIGHTS RD
Second Line : SUITE E
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1591
Country : US
Telephone Number : 847-577-1501
Fax Number : 847-577-1501
Provider Business Practice Location Address
First Line : 3345 N ARLINGTON HEIGHTS RD
Second Line : SUITE E
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1591
Country : US
Telephone Number : 847-577-1501
Fax Number : 847-577-3858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2008
Last Update Date : 03/10/2017

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