Provider Demographics
NPI:1629264064
Name:NOVAK, JAIMEE LEA (MS, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JAIMEE
Middle Name:LEA
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 OLD GLENVIEW RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2963
Mailing Address - Country:US
Mailing Address - Phone:847-256-2000
Mailing Address - Fax:847-256-2300
Practice Address - Street 1:3330 OLD GLENVIEW RD
Practice Address - Street 2:SUITE 15
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2963
Practice Address - Country:US
Practice Address - Phone:847-256-2000
Practice Address - Fax:847-256-2300
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008078101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional