Provider Demographics
NPI:1619382660
Name:PROHASKA-SLATTERY, MONIQUE (LCPC)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:PROHASKA-SLATTERY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:
Other - Last Name:PROHASKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:911 N ELM ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:815-514-8992
Mailing Address - Fax:
Practice Address - Street 1:911 N ELM ST
Practice Address - Street 2:SUITE 316
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3634
Practice Address - Country:US
Practice Address - Phone:815-514-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional