Provider Demographics
NPI:1497443451
Name:DOMANICO JALOVEC, ADRIANNA T (LCSW, MBA, PMH-C)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:T
Last Name:DOMANICO JALOVEC
Suffix:
Gender:F
Credentials:LCSW, MBA, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:442 S CRAIG PL
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2712
Mailing Address - Country:US
Mailing Address - Phone:630-202-7267
Mailing Address - Fax:
Practice Address - Street 1:3250 N ARLINGTON HEIGHTS RD UNIT 300
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1500
Practice Address - Country:US
Practice Address - Phone:847-934-7969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0253901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical