Provider Demographics
NPI:1508245176
Name:DAVE, ROSHNI (LCPC)
Entity Type:Individual
Prefix:MS
First Name:ROSHNI
Middle Name:
Last Name:DAVE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EXECUTIVE CT
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9550
Mailing Address - Country:US
Mailing Address - Phone:224-655-2487
Mailing Address - Fax:
Practice Address - Street 1:10 EXECUTIVE CT
Practice Address - Street 2:SUITE 5
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9550
Practice Address - Country:US
Practice Address - Phone:224-655-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health