Provider Demographics
NPI:1346395654
Name:DELAURENTIS, GINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:DELAURENTIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:DANEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3634 192ND ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-4204
Mailing Address - Country:US
Mailing Address - Phone:708-955-8669
Mailing Address - Fax:
Practice Address - Street 1:120 SPALDING DR STE 111
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6766
Practice Address - Country:US
Practice Address - Phone:630-646-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490115121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical