Provider Demographics
NPI:1013597483
Name:MOZO, HOPE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:
Last Name:MOZO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 HALF DAY ROAD
Mailing Address - Street 2:PMB 284
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089
Mailing Address - Country:US
Mailing Address - Phone:312-857-5122
Mailing Address - Fax:
Practice Address - Street 1:100 N WAUKEGAN RD STE 204
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1660
Practice Address - Country:US
Practice Address - Phone:847-821-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional