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NPI Code Detail

MEDICARE: THERESA S RO LPC

MEDICARE: THERESA S RO LPC
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
1101YP2500XProfessional Counselor
2101YP2500XProfessional Counselor178.016851IL

General Provider Information

NPI Number : 1215517453
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA S RO LPC
Provider Business Mailing Address
First Line : 3325 N ARLINGTON HEIGHTS RD STE 400C
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1576
Country : US
Telephone Number : 312-741-3511
Fax Number :
Provider Business Practice Location Address
First Line : 3325 N ARLINGTON HEIGHTS RD STE 400C
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1576
Country : US
Telephone Number : 312-741-3511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2021
Last Update Date : 05/19/2024

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Directions to “ THERESA S RO LPC” Practice Location

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