Provider Demographics
NPI:1558964908
Name:LOZANO, NATIYA MONIQUE (LCPC, RDMT)
Entity Type:Individual
Prefix:
First Name:NATIYA
Middle Name:MONIQUE
Last Name:LOZANO
Suffix:
Gender:F
Credentials:LCPC, RDMT
Other - Prefix:MRS
Other - First Name:NATIYA
Other - Middle Name:M
Other - Last Name:REGGANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, RDMT
Mailing Address - Street 1:30 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-279-9981
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 424
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3844
Practice Address - Country:US
Practice Address - Phone:312-279-9981
Practice Address - Fax:312-279-9981
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180013750225600000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R-DMTOtherAMERICAN DANCE THERAPY ASSOCIATION