Provider Demographics
NPI:1417336777
Name:GRENESKO-STEVENS, EMILY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:GRENESKO-STEVENS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:GRENESKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1534 BASSWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2007
Mailing Address - Country:US
Mailing Address - Phone:773-263-9172
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1505
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-600-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.001249106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program