MEDICARE: MS. ELIZABETH HAINES M.S., LCPC, NCC

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
1	101YP2500X	Professional Counselor	178.010436	IL
2	101YP2500X	Professional Counselor	180.013046	IL

General Provider Information

NPI Number	:	1235517103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH HAINES M.S., LCPC, NCC

Provider Business Mailing Address
First Line	:	675 N NORTH CT STE 360
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8131
Country	:	US
Telephone Number	:	847-241-1875
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 N NORTH CT STE 360
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8131
Country	:	US
Telephone Number	:	847-241-1875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	04/21/2022

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