Provider Demographics
NPI:1497120620
Name:DUBIEL, ELIZABETH LAITMAN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LAITMAN
Last Name:DUBIEL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:HAZEL
Other - Last Name:LAITMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1316 WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4226
Mailing Address - Country:US
Mailing Address - Phone:708-369-0289
Mailing Address - Fax:
Practice Address - Street 1:1316 WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4226
Practice Address - Country:US
Practice Address - Phone:708-369-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011155101YM0800X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health