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NPI Code Detail

MEDICARE: MS. ROSALIE P DEYOUNG MA, LCPC

MEDICARE:  MS. ROSALIE P DEYOUNG  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 Counselor180001302IL

General Provider Information

NPI Number : 1952627192
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSALIE P DEYOUNG MA, LCPC
Provider Business Mailing Address
First Line : 1230 N HIGHLAND AVE
Second Line :
City : AURORA
State : IL
Zip : 60506-1401
Country : US
Telephone Number : 630-966-4314
Fax Number : 630-859-8472
Provider Business Practice Location Address
First Line : 1230 N HIGHLAND AVE
Second Line :
City : AURORA
State : IL
Zip : 60506-1401
Country : US
Telephone Number : 630-966-4314
Fax Number : 630-859-8472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2010
Last Update Date : 04/13/2010

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Directions to “ MS. ROSALIE P DEYOUNG MA, LCPC” Practice Location

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