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NPI Code Detail

MEDICARE: LUCIA DAVALOS TERRAZAS LCPC

MEDICARE: LUCIA DAVALOS TERRAZAS 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
1101YP2500XProfessional Counselor180.015810IL

General Provider Information

NPI Number : 1972448595
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIA DAVALOS TERRAZAS LCPC
Provider Business Mailing Address
First Line : 1645 W OGDEN AVE UNIT 641
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4386
Country : US
Telephone Number : 312-918-7640
Fax Number :
Provider Business Practice Location Address
First Line : 2319 S DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4209
Country : US
Telephone Number : 773-579-0832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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Directions to “ LUCIA DAVALOS TERRAZAS LCPC” Practice Location

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