Provider Demographics
NPI:1275203887
Name:GOERING, JOSIAH (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JOSIAH
Middle Name:
Last Name:GOERING
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N WAUKEGAN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-1660
Mailing Address - Country:US
Mailing Address - Phone:224-252-4951
Mailing Address - Fax:
Practice Address - Street 1:100 N WAUKEGAN RD STE 204
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1660
Practice Address - Country:US
Practice Address - Phone:847-821-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health