Provider Demographics
NPI:1609418607
Name:SHCHERBAKOVA, YEKATERINA (LCPC)
Entity Type:Individual
Prefix:
First Name:YEKATERINA
Middle Name:
Last Name:SHCHERBAKOVA
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 1:345 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4111
Mailing Address - Country:US
Mailing Address - Phone:708-386-2157
Mailing Address - Fax:
Practice Address - Street 1:345 MADISON ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4111
Practice Address - Country:US
Practice Address - Phone:708-386-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011350101YM0800X, 101YP2500X
IL1800011350101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health