Provider Demographics
NPI:1093036055
Name:GOMEZ, STEVEN MARK (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MARK
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3375 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7701
Mailing Address - Country:US
Mailing Address - Phone:847-577-4530
Mailing Address - Fax:847-577-4306
Practice Address - Street 1:3375 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE F
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7701
Practice Address - Country:US
Practice Address - Phone:847-577-4530
Practice Address - Fax:847-577-4306
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL178004917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional