Provider Demographics
NPI:1134678121
Name:MAROTTA, THERESA (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:MAROTTA
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 E ALGONQUIN RD STE 405
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4159
Mailing Address - Country:US
Mailing Address - Phone:847-701-4191
Mailing Address - Fax:
Practice Address - Street 1:2030 E ALGONQUIN RD STE 405
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4159
Practice Address - Country:US
Practice Address - Phone:847-701-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
57253101Y00000X
IL18049101YA0400X
IL180-004565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)