MEDICARE: CARLI CINQUEGRANI LPC-INTERN

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	178.020106	IL

General Provider Information

NPI Number	:	1528755220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLI CINQUEGRANI LPC-INTERN

Provider Business Mailing Address
First Line	:	414 PLAZA DR STE 301
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-5508
Country	:	US
Telephone Number	:	630-812-8424
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 W OHIO ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-1266
Country	:	US
Telephone Number	:	630-812-8424
Fax Number	:

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

Provider Enumeration Date	:	04/21/2023
Last Update Date	:	04/23/2024

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Directions to “ CARLI CINQUEGRANI LPC-INTERN” Practice Location

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