Provider Demographics
NPI:1639820277
Name:SOLDATI, JENNA (LCPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:SOLDATI
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 1:4838 N ASHLAND AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3475
Mailing Address - Country:US
Mailing Address - Phone:773-770-5005
Mailing Address - Fax:
Practice Address - Street 1:4838 N ASHLAND AVE APT 3E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3475
Practice Address - Country:US
Practice Address - Phone:630-818-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180015506101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional