Provider Demographics
NPI:1649380791
Name:TRIPPIEDI, LAURA LEE (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:TRIPPIEDI
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 W HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-8964
Mailing Address - Country:US
Mailing Address - Phone:815-558-1602
Mailing Address - Fax:
Practice Address - Street 1:7307 N ALPINE RD STE A6
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-1803
Practice Address - Country:US
Practice Address - Phone:815-444-0751
Practice Address - Fax:815-206-8976
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health