Provider Demographics
NPI:1659960367
Name:FLECKENSTEIN, DANIELLE (ALMFT, LPC, CCLS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:ALMFT, LPC, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 S KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3527
Mailing Address - Country:US
Mailing Address - Phone:708-341-6117
Mailing Address - Fax:
Practice Address - Street 1:53 W JACKSON BLVD STE 632
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3667
Practice Address - Country:US
Practice Address - Phone:312-659-4718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017701101YM0800X
101YM0800X
IL208.000969106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health