Provider Demographics
NPI:1639311129
Name:VANPELT, JOSHUA JOEL (MA, LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JOEL
Last Name:VANPELT
Suffix:
Gender:M
Credentials:MA, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-6165
Mailing Address - Country:US
Mailing Address - Phone:847-377-8400
Mailing Address - Fax:847-360-9372
Practice Address - Street 1:2400 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6165
Practice Address - Country:US
Practice Address - Phone:847-377-8400
Practice Address - Fax:847-360-9372
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007035101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health