Provider Demographics
NPI:1184032179
Name:PALACIOS, BRIANNA (LCPC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7944 W 82ND ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1640
Mailing Address - Country:US
Mailing Address - Phone:734-834-8119
Mailing Address - Fax:
Practice Address - Street 1:70 S RIVER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-5185
Practice Address - Country:US
Practice Address - Phone:630-844-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor