Provider Demographics
NPI:1447736921
Name:MARANTO, JOSEPH VINCENT (MA, LCPC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:VINCENT
Last Name:MARANTO
Suffix:
Gender:M
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 1:10605 LOWERY CT
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-7522
Mailing Address - Country:US
Mailing Address - Phone:708-710-3812
Mailing Address - Fax:
Practice Address - Street 1:15300 WEST AVE STE 313
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4687
Practice Address - Country:US
Practice Address - Phone:708-460-2721
Practice Address - Fax:708-226-2621
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health