Provider Demographics
NPI:1194204495
Name:BIELESCH, ALEXANDER REINHOLD (LPC, BCBA)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:REINHOLD
Last Name:BIELESCH
Suffix:
Gender:M
Credentials:LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 ROHLWING RD STE C
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1300
Mailing Address - Country:US
Mailing Address - Phone:773-315-3177
Mailing Address - Fax:
Practice Address - Street 1:1951 ROHLWING RD STE C
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1300
Practice Address - Country:US
Practice Address - Phone:847-961-2679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-21-51396103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst