Provider Demographics
NPI:1558782144
Name:GOGLIOTTI, GAIL (LCPC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:GOGLIOTTI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:ADDUCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3634 N TRIPP AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3037
Mailing Address - Country:US
Mailing Address - Phone:708-525-6152
Mailing Address - Fax:
Practice Address - Street 1:6601 N AVONDALE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1572
Practice Address - Country:US
Practice Address - Phone:773-340-1715
Practice Address - Fax:773-496-7305
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional