Provider Demographics
NPI:1285826412
Name:JASKE, ORENZA LETIZIA (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:ORENZA
Middle Name:LETIZIA
Last Name:JASKE
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MISS
Other - First Name:ORENZA
Other - Middle Name:LETIZIA
Other - Last Name:VISCONTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LCPC
Mailing Address - Street 1:1008 E GLAVIN CT APT 4
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2204
Mailing Address - Country:US
Mailing Address - Phone:847-338-9076
Mailing Address - Fax:847-426-4219
Practice Address - Street 1:600 SPRING HILL RING RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-7300
Practice Address - Country:US
Practice Address - Phone:847-338-9076
Practice Address - Fax:847-426-4219
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005272101YP2500X
IL26805101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)