Provider Demographics
NPI:1083315402
Name:NAURECKAS, MAUREEN GRACE (LPC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:GRACE
Last Name:NAURECKAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:MARTIN
Other - Last Name:NAURECKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4849 N MILWAUKEE AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2191
Mailing Address - Country:US
Mailing Address - Phone:773-492-0913
Mailing Address - Fax:
Practice Address - Street 1:4849 N MILWAUKEE AVE STE 503
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2191
Practice Address - Country:US
Practice Address - Phone:773-492-0913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health