Provider Demographics
NPI:1215224571
Name:BUDRUWEIT, JENNIFER NICOLE (BA, MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NICOLE
Last Name:BUDRUWEIT
Suffix:
Gender:F
Credentials:BA, MA, LCPC
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:CHIANELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, MA
Mailing Address - Street 1:200 W HIGGINS RD
Mailing Address - Street 2:SUITES 205, 231
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195
Mailing Address - Country:US
Mailing Address - Phone:888-234-7628
Mailing Address - Fax:888-234-7628
Practice Address - Street 1:200 W HIGGINS RD
Practice Address - Street 2:SUITES 205, 231
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195
Practice Address - Country:US
Practice Address - Phone:888-234-7628
Practice Address - Fax:888-234-7628
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008946101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional