Provider Demographics
NPI:1164826483
Name:SANT, MANSI (LCPC, CEDS)
Entity Type:Individual
Prefix:
First Name:MANSI
Middle Name:
Last Name:SANT
Suffix:
Gender:F
Credentials:LCPC, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 GLENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-5499
Mailing Address - Country:US
Mailing Address - Phone:773-547-0800
Mailing Address - Fax:
Practice Address - Street 1:24014 W RENWICK RD UNIT 105
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-8729
Practice Address - Country:US
Practice Address - Phone:773-547-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health