Provider Demographics
NPI:1437265600
Name:BRZOSTOWSKI, DANIEL J (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:BRZOSTOWSKI
Suffix:
Gender:M
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-1219
Mailing Address - Country:US
Mailing Address - Phone:847-255-0224
Mailing Address - Fax:
Practice Address - Street 1:324 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-1219
Practice Address - Country:US
Practice Address - Phone:847-255-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional