Provider Demographics
NPI:1003961970
Name:DRENGENBERG, CAROL HELAINE (RN, LCPC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:HELAINE
Last Name:DRENGENBERG
Suffix:
Gender:F
Credentials:RN, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SKOKIE BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4013
Mailing Address - Country:US
Mailing Address - Phone:847-272-7608
Mailing Address - Fax:847-272-5863
Practice Address - Street 1:910 SKOKIE BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4013
Practice Address - Country:US
Practice Address - Phone:847-272-7608
Practice Address - Fax:847-272-5863
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional