Provider Demographics
NPI:1518553825
Name:RANGEL, VANESA (LCPC)
Entity Type:Individual
Prefix:
First Name:VANESA
Middle Name:
Last Name:RANGEL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:VANESA
Other - Middle Name:
Other - Last Name:RANGEL-HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:213 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3931
Mailing Address - Country:US
Mailing Address - Phone:630-354-8886
Mailing Address - Fax:
Practice Address - Street 1:3 FRIENDSHIP PLZ
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2787
Practice Address - Country:US
Practice Address - Phone:630-693-7934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.103287101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional