Provider Demographics
NPI:1235846627
Name:KRZEMINSKA, AGNIESZKA (LCPC, NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:KRZEMINSKA
Suffix:
Gender:F
Credentials:LCPC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 HONEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1248
Mailing Address - Country:US
Mailing Address - Phone:224-639-6222
Mailing Address - Fax:
Practice Address - Street 1:11618 MCCONNELL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7384
Practice Address - Country:US
Practice Address - Phone:224-400-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180013610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health