Provider Demographics
NPI:1295036846
Name:FRIEDMAN, NANCY AGOSTINELLI (MA, LCPC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:AGOSTINELLI
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 PEBBLE CREEK DR.
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3202
Mailing Address - Country:US
Mailing Address - Phone:847-650-3266
Mailing Address - Fax:847-729-1410
Practice Address - Street 1:1740 WAUKEGAN RD.
Practice Address - Street 2:SUITE 10
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025
Practice Address - Country:US
Practice Address - Phone:847-650-3266
Practice Address - Fax:847-729-1410
Is Sole Proprietor?:No
Enumeration Date:2010-11-13
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178005504101Y00000X
IL180007686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor